AMC successfully performs a liver transplant on the Russian patient deemed untreatable in Japan

Mr. Alexei (male, age 27), a Russian patient whose life was at risk from alcoholic cirrhosis, was discharged in early March after receiving a liver transplant at AMC. The liver transplantation team’s successful operation on Mr. Alexei, who had been denied surgery at Hokkaido University Hospital in Japan, was recently featured in the media.
Japan is the country where the world’s first successful adult living donor liver transplantation (LDLT) was performed in 1993, laying a major cornerstone in the history of organ transplantation. Hokkaido University Hospital in particular, where Mr. Alexei first sought treatment, is considered one of Japan’s top three liver transplant centers.
The only treatment option for Mr. Alexei was a liver transplant, but Dr. Takashi Aoyagi, Mr. Alexei’s physician at Hokkaido University Hospital, determined that the surgery was not feasible because of the patient’s serious condition.
This decision was also influenced by the age the intended donors (the patient’s mother Irena is 50 and his aunt Galena is 46), as well as the small size of their livers. When they were told that the procedure could not be done in Japan, where they had gone with such great hopes, Mr. Alexei and his family were disappointed.
Eventually, Dr. Aoyagi contacted Dr. Sung-Gyu Lee of AMC’s Division of Liver Transplantation and Hepato-Biliary Surgery, who has abundant experience with LDLTs and who has been producing excellent outcomes in 2:1 liver transplants.
When asked to consider treatment for the patient, Dr. Lee concluded that it was possible to perform a 2:1 liver transplant, using sections donated from the livers of the patient’s mother and aunt. A 2:1 liver transplant is a highly advanced surgical procedure used when the donor’s liver is small. It involves detaching parts of two donors’ livers and transplanting them into one patient. In Japan, only about ten cases of 2:1 liver transplants have been performed so far.
On the other hand, since the world’s first successful 2:1 liver transplant was achieved at AMC in March 2000, the hospital has performed 363 such procedures to date, a world’s record.
Liver transplantation is feasible even when the recipient’s and donor’s blood types are not compatible. In liver transplantation, the total volume of liver that is transplanted is key.
AMC was the first medical institution in Korea to apply the techniques for performing a successful ABO-incompatible liver transplant, which is another reason behind AMC’s record-breaking number of liver transplants.
After being admitted to AMC together with his donors on Dec. 28, Mr. Alexei underwent a 20-hour liver transplantation surgery on Jan. 16, performed by Dr. Sung-Gyu Lee. For the surgery, 600 grams were detached from his aunt’s right lobe and 350 grams from his mother’s left lobe.
The surgery was successful. After receiving 950 grams of donated liver, Mr. Alexei came to have normal adult liver function.
Restored to health, Mr. Alexei expressed his thanks to the medical staff, saying, “ If I had come to Korea in the first place for a liver transplant instead of going to the trouble of traveling to Japan, I could have had the operation much sooner.
I’m going to tell everyone about the excellence of Korean medicine when I return home.” Dr. Lee said, “For serious cases, you need plenty of experience and intensive critical care in order to perform advanced procedures such as 2:1 liver transplants.
At present, there are only a few medical institutions worldwide with such capabilities, and AMC is one of them.
In the initial history of organ transplantation worldwide, Japanese and American medical institutions were the shining stars. But currently, with respect to medical technology, Korea is not only equal to those nations, but is also a world leader in some procedures, including LDLTs.
In fact, medically advanced countries refer cases and request treatment from us.” In 2011, the Organ Transplantation Center successfully performed 403 liver transplants, a one-year world record.
And it is poised to become a global Mecca of liver transplantation, with over 100 foreign medical scientists having come to AMC for study and training.