Seoung Hoon Kim¹, Ke Liao²

¹Center for Liver Cancer, National Cancer Center, Goyang 10408, Gyeonggi-do, South Korea; ²HBSN Editorial Office, AME Publishing Company.

Editor’s NoteThe 9th Joint Conference of the University of Chicago and PUMCH Liver Surgery was successfully held at Beijing, China from Sept 8 to 9, 2023. This year’s conference focused on the significant advances for the treatment of hepatobiliary pancreatic diseases that occurred despite the limitations brought on by COVID. Taking this opportunity, we conducted an interview with Prof. Seoung Hoon Kim from National Cancer Center, Goyang, Korea.

Expert’s introduction

Prof. Seoung Hoon Kim is a staff surgeon of Center for Liver and Pancreatobiliary Cancer, the chief of Organ Transplantation Center, and a Chief scientist, Division of Clinical Research at National Cancer Center, Korea.

He received his medical degree at the Seoul National University College of Medicine in 1996 and completed training in surgery at the Seoul National University Hospital in 2001. He also obtained a PhD from Seoul National University Graduate School of Medicine in 2006.

He is, as liver transplant & hepatobiliary surgeon, focusing on better outcome of both hepatectomy and liver transplantation in living donors and patients with a diseased liver. He has published more than 50 peer-reviewed articles and book chapters as a first or corresponding author.

He set up the liver transplantation program in his institution in 2005.He is renowned for having pioneered surgical techniques like various liver resections using hanging maneuver, upper midline laparotomy in major liver resection, minimal anhepatic technique in right lobe living donor liver transplantation. YouTube made his surgical performances even easier to appreciate. And he is good at all procedures of LDLT including microsurgery in hepatic artery anastomosis as well as donor & recipient surgery. His personal experience is based on practice for 20 years with more than 800 cases of LDLT and 1500 cases of liver resection.

Interview

HBSN: Looking towards the future and what do you believe is the most important direction for the study of the living donor surgery?

Prof. Kim: As you know that the living donor surgery is an important part of the living donor liver transplant. Living donor liver transplant requires that two operations should be performed simultaneously. One is donor operation, the other is recipient operation.

In donor operation, donor has no disease. The command, “First, Do No Harm,” etches in bold the physician's paramount duty: to sidestep causing harm or needless suffering to those in their care. The donor surgery seems completely contradictory to this tenet. Why is a donor’s surgery needed? Because the doctors have to save the donor’s beloved one, like his father, mother or anyone else who is in critical condition. Without operations, the recipient would die, so that's why donor operation is needed.

In Living Donor Liver Transplant, the most important thing is donor’s safety. We have to secure donor’s safety whatever it costs to. But how can we secure a donor’s safety? It is divided into three areas. First thing is preoperative donor’s selection based on the whole evaluation that include comprehensive medical tests and psychologic workup.

The second thing is surgical technique which depends on surgeon's hand. The surgeons play a vital role in this part. Donor safety is ensured by no or minimal bleeding during surgery. It is mandatory. Besides, safe and accurate resection is indispensable. The liver has its own unique anatomy by portal vein, hepatic vein, bile duct, and hepatic artery. These important components should be kept in mind for a perfect surgery.

The third important thing is postoperative management. The surgeon must pay close attention to the postoperative period because any unexpected event can happen, which may lead to serious morbidity or even mortality of a living donor.

Preoperative donor’s selection, Surgical technique, and postoperative monitoring and management are very important. All three points mentioned above should be done completely.

HBSN: As a reputable expert in liver surgery, what originally drive you into this field at the first place?

Prof. Kim: That’s an interesting question. Let's go back to my younger days. When I was in medical school, I observed some patients with end-stage liver diseases. Unlike other diseases, liver disease may cause lots of serious symptoms and signs such as the yellow face, jaundice, ascites and abdominal distention. When liver function is deteriorated, the patients have bleeding or encephalopathy, the patients’ condition is deteriorating with time. However, these patients can recover by liver transplantation. The liver transplantation fascinated me. I was inspired. I think that's what I want to do in the future. That's why I chose liver surgery.

HBSN: Since our conference mentioned the epidemic era. What it has posed challenges for treating liver diseases. So, what behaviors might induce liver damage? Do the medications for the colds harm the liver?

Prof. Kim: In the liver transplantation, the patient is likely to be infected. Not only Covid-19 can affect, but also other infectious agents in the air. Many infection agents like biter, bacteria and fungi can be contacted with the recipients. In that situation, the recipients received immune systems depression. As the patients’ immune systems depress so easily, we need to prevent the infection by antibiotics and hygiene. As you said, the medication for cough can affect the patients, especially for the patients who are sensitive to drugs. Usually when patients have cough, we will use Tylenol to lower temperature, but for some patients who’re highly sensitive to drugs, Tylenol (acetaminophen) will cause liver impairment. Therefore, when giving the patients drugs, the doctors should be very cautious and conservative with prescription.

HBSN: We realized that over the years, you have already published many excellent research papers, so what is secret to maintain such a high level of academic enthusiasm?

Prof. Kim: I’m still endeavoring to improve better outcome for patients. The better outcome means reducing morbidity and mortality. If surgery is inevitable, only best surgery is necessary. Surgery must be done safely and quickly. There are many methods and innovational surgical techniques and management worldwide. However, I’m not satisfied with them. We need to make our efforts to find far better techniques and management.

HBSN: As an experienced professor of this field do you have any word to your younger physicians who would like to engage in your field? And what do you think is a key to success?

Prof. Kim: I don't think I've been very successful in this field. For the younger generation, I want to tell them that their spirits and attitudes are precious. Young doctors, especially medical students, may hope to become successful liver transplant surgeons one day. It is good to have this hope. However, if you want to become a qualified surgeon, you must do your best to make your dream a reality. Sometimes unexpected obstacles may arise. I hope you can overcome difficulties and move forward without hesitation. Don’t give up. No matter what happen, remember to do your best to achieve your goal of becoming a surgeon.