pISSN 2671-8790 eISSN 2671-8804

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Korean J Transplant 2022; 36(3): 231-235

Published online September 30, 2022

https://doi.org/10.4285/kjt.22.0033

© The Korean Society for Transplantation

The significance of the first living donor kidney transplantation in Jeju: a case report

Young-Heun Shin1 , Taeseung Lee1 , Won-Bae Chang2

1Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
2Department of Surgery, Jeju National University Hospital, Jeju, Korea

Correspondence to: Won-Bae Chang
Department of Surgery, Jeju National University Hospital, 15 Aran 13-gil, Jeju 63241, Korea
Tel: +82-64-717-2287
Fax: +82-64-757-8276
E-mail: wbchangmd@gmail.com

Received: July 8, 2022; Accepted: August 1, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To overcome the shortage of kidney donors, diverse methods have been utilized, including living donor kidney transplantation (LDKT) and extended criteria for deceased donor grafts. Currently, LDKT is a major treatment option. However, in Jeju, deceased donor kidney transplantation (DDKT) has been restricted due to the prolonged cold ischemia time (CIT) caused by the island’s geographic disadvantages and transportation limitations. We report the first LDKT in Jeju, which demonstrates a means of overcoming prolonged CIT. A 67-year-old male patient with diabetic nephropathy underwent a preemptive ABO compatible LDKT (ABO type O+) from his 62-year-old wife. The operation was uneventful, using anti-thymocyte globulin based on the recipient’s medical and immunologic risks. The patient recovered without significant complications and was discharged on postoperative day 15. Follow-up Doppler ultrasonography showed good blood flow to the kidney, and his serum creatinine levels steadily decreased and remained stable. The first successful LDKT in Jeju was significant in that kidney transplantation was implemented by compensating for its geographic limitations. In addition, we review machine perfusion as another method of avoiding prolonged CIT.

Keywords: Living donors, Kidney transplantation, Cold ischemia, Perfusion

HIGHLIGHTS
  • Living donor kidney transplantation (LDKT) and expansion of the criteria for deceased donor grafts have been utilized to overcome the shortage of kidney donors.

  • The geography and resulting transportation limitations of Jeju place it at risk for prolonged cold ischemia time (CIT) in deceased donor kidney transplantations, especially in marginal donor grafts.

  • The first successful LDKT in Jeju is significant in that it compensated for the disadvantages of its geography.

  • Machine perfusion is a good alternative for overcoming prolonged CIT in Jeju.