The Seoul National University Hospital, with the support of the Georgian Embassy in Seoul, completed the first successful living donor liver transplant in Tbilisi in March, opening doors for more medical cooperation between Georgia and Korea.

SNUH surgeon Dr. Lee Kwang-woong performed the operation, together with a colleague, an anesthesiologist and a nurse who were all from Georgia. In the operation, 18-year-old Mariam Gobejishvili donated 60 percent of her liver to her 55-year-old father Gocha Gobejishvili.

Lee visited Georgia in February to examine the facility and faculty of the Aversi Clinic, where the surgery was performed, and gave the green light for the operation. The clinic purchased equipment from a list prescribed by SNUH. 

“I decided to have an operation several months ago, and my daughter was the first one to decide to be a donor,” Gocha told the Georgian press.

“At first, I refused, as I was worried about her health. However, we entrusted our health to the clinic.”

The clinic is a private hospital managed by a pharmaceutical company. Most doctors are university professors educated in Europe.

The partnership was first suggested by Georgian surgeon Koba Shanava, who did a 6-month internship at SNUH under Lee’s supervision last year.

A Georgian anesthesiologist did a 3-week internship at SNUH in March before the surgery, and a clinical pathologist and three surgeons participated in a monthlong training program in June.

“It is critical to maintain high operational standards, as upheld by the SNUH liver team,” Aversi Clinic surgeon Nikoloz Ubiria told The Korea Herald. “A new organization like us needs to learn the medical ‘culture’ -- how the operation is planned and executed, and post-operation is managed.”

“Dedication, precision and professionalism result in a successful operation, with a healthy recipient and donor.”

The Georgian Embassy in Seoul provided administrative support, and aims to expand medical cooperation to more fields, surgeon Koba Shanava said.

The team completed a second successful operation in May. Since then, the number of patients waiting to be operated on at the clinic has multiplied.

Liver transplants are split into diseased donor and living donor types. The former involves a dead person, and is relatively easy to execute, according to Lee. The latter is more difficult, as the donor’s safety must be taken into account.

Both operations are for patients with a terminal liver disease, who must undergo the surgery to survive. A long list of causes -- hepatitis B and C, alcohol overconsumption and cancer – can lead to terminal liver failure.

The surgery is highly complicated and a complex post-operation procedure is required, Lee said. 

“I consider myself a second generation Korean liver transplant surgeon, who learned from senior compatriots, unlike the first generation who learned from Western and Japanese doctors,” Lee said.

“It’s about time Korea shared its experience with other countries. Interactions such as this will raise both countries’ profiles with one another, and save lives.”

Korea is at the world’s top level in living donor surgery, in terms of technique, survival rate and the number of operations per million people, according to Lee. The five-year survival rate for recipients in Korea is over 90 percent, compared to around 80 percent in Europe.

Georgia’s health care and insurance are largely state-managed alongside private clinics. Patients do not pay for emergency operations, and nonemergency care is half-covered. The government currently does not provide financial support for living donor liver transplants.

“It is our goal to demonstrate to the government that this program will work in Georgia,” Ubiria said, urging financial, administrative and legal backing from his government.

By Joel Lee (joel@heraldcorp.com)