M H Lin

Publications (20)23.75 Total impact

• Article: Steroid pulse therapy combined with plasmapheresis for clinically compromised patients after heart transplantation.

  H-W Chou, N-H Chi, M-H Lin, N-K Chou, C-I Tsao, H-Y Yu, Y-S Chen, S-S Wang
  [show abstract] [hide abstract]
  ABSTRACT: The most serious complication after heart transplantation is allograft dysfunction. Patients presenting with compromised hemodynamics show a high incidence of mortality. The most common reason for allograft dysfunction is rejection. We have employed steroid pulse therapy combined with plasmapheresis for hemodynamically compromised patients after heart transplantation. Steroid pulse therapy and plasmapheresis were performed on 35 patients who underwent orthotopic heart transplantation for graft dysfunction. Thus treatment rescued ventricular function and improved the ejection fraction in 77% of patients, among who ever 71.4% showed improved New York Heart Association (NYHA) functional class. Steroid pulse therapy combined with plasmapheresis improved the cardiac contractility and NYHA functional class of most heart transplant recipients with graft dysfunction.
  Transplantation Proceedings 05/2012; 44(4):900-2. · 1.00 Impact Factor
• Article: The outcome of heart transplantation in hepatitis C-positive recipients.

  M-H Lin, N-K Chou, N-H Chi, Y-S Chen, H-Y Yu, S-C Huang, W-J Ko, H-W Chou, S-S Wang
  [show abstract] [hide abstract]
  ABSTRACT: Clinical outcomes of heart transplantation (HTx) among recipients with chronic hepatitis C virus (HCV) infection are poorly understood especially in Asia. Therefore, this study evaluated these clinical outcomes. Using retrospective chart review we collected data on 385 patients including 20 HCV-positive recipients at the time of transplantation. We obtained information on demographics features, serial transaminases, graft function, patient survival as well as the incidences of acute hepatitis and transplant coronary artery disease. Between 1987 and 2010, the 20 HCV-positive patients had a median age at transplantation of 52 years (range, 30-63). Seventeen were men and three women. All the patients were classified as Child-Pugh class A; two had cirrhosis prior to HTx. Over a mean follow-up of 63 months (range, 2 days to 187 months), there were 11 deaths, including two hospital mortalities and nine subsequent deaths. Only one mortality (5%) was related to Child-Pugh class C cirrhosis, despite liver transplantation. Among the other 19 deceased or surviving recipients, there was no evidence of hepatic dysfunction or hepatocellular carcinoma. Transplant coronary artery disease was detected in six patients (30%). There was no significant difference in Kaplan-Meier actuarial survival between the HCV-positive and HCV-negative recipients (P = .59). There was no significant difference in patient survival or graft function between HCV-positive and HCV-negative HTx recipients. Additionally, HCV-positive recipients were not at an increased risk of hepatic failure or accelerated transplant coronary artery disease.
  Transplantation Proceedings 05/2012; 44(4):890-3. · 1.00 Impact Factor
• Article: The relationship between optimism and life satisfaction for patients waiting or not waiting for renal transplantation.

  M H Lin, Y J Chiang, C L Li, H E Liu
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: The purpose of this study was to explore the relationship between optimism and life satisfaction among patients with end-stage renal disease who decide to wait or not to wait for kidney transplantation. This cross-sectional, correlation design study was performed from July 2007 to June 2008. Subjects were recruited by purposive sampling in the clinics of kidney transplantation, renal disease, hemodialysis, and peritoneal dialysis. Three hundred fifty questionnaires were distributed, we analyzed the 335 returned including 196 subjects in the waiting group and 139 in the non-waiting group. Parameters included patient basic information, optimism, and life satisfaction scales. Data were analyzed by independent t-student's, chi-square, Pearson correlation, and stepwise multiple regression tests. The subjects in both the waiting and non-waiting groups reported moderate levels of life satisfaction; whereas, the latter reported a greater life satisfaction in general. All participants had good optimism that was positively related to their life satisfaction. Other factors of optimism, age, work ability, waiting transplantation or not, and marriage status were also significantly associated with life satisfaction.
  Transplantation Proceedings 04/2010; 42(3):763-5. · 1.00 Impact Factor
• Article: Outcome in children bridged and nonbridged to cardiac transplantation.

  M H Lin, N K Chou, Y S Chen, N H Chi, W J Ko, H Y Yu, S C Huang, N T Wu, J K Wang, M H Wu, S S Wang
  [show abstract] [hide abstract]
  ABSTRACT: Heart transplantation (HTx) in children with end-stage heart disease has become an accepted treatment option. To evaluate our results of pediatric cardiac transplantation with vs without bridge methods. The study included 31 patients (34 transplantations) younger than 18 years who underwent orthotopic HTx between March 1995 and December 2008. Ten patients were girls, and 21 were boys. Preoperative diagnoses included cardiomyopathy (n=20), congenital heart disease (n=7), hypertrophic cardiomyopathy (n=2), restrictive cardiomyopathy (n=1), and ischemic cardiomyopathy (n=1). Mean (SD) ischemia time was 185 (72) minutes. Thirty-day mortality was 6%, and was due to primary graft failure (n=2). Overall follow-up was 4.36 (3.93) years. Eleven patients underwent bridge techniques before HTx, and 11 patients required perioperative extracorporeal membrane oxygenation or ventricular assist device support. In the group that received extracorporeal membrane oxygenation, 8 patients (73%) were successfully weaned and discharged with excellent functional class. There were no differences in operative mortality, functional class, survival, rejection, and infection rates between the bridged and nonbridged groups. Overall actuarial 1- and 5-year survival rates were 93% and 83%, respectively. All survivors had good functional class. Our findings demonstrate satisfactory medium-term outcome of HTx in selected pediatric patients with end-stage heart disease. Using bridge methods in children at high risk can increase the opportunity to receive a donor heart. These bridge methods achieve similar postoperative outcomes.
  Transplantation Proceedings 04/2010; 42(3):916-9. · 1.00 Impact Factor
• Article: Analysis of the factors influencing living kidney donation: the experience in National Taiwan University Hospital.

  M H Lin, M K Tasi, H Y Lin, C H Lee, S C Chen, P H Lee
  [show abstract] [hide abstract]
  ABSTRACT: Kidney transplantation provides a choice of active treatment for patients with chronic renal failure. However, the sources of organs are limited; therefore, living kidney donation is an alternative source. The regulation of organ donation in Taiwan stipulates that living organ donation is restricted to living related recipients. We sought to investigate factors that influenced or prevented individuals from living kidney donation in our center. From January 2005 to December 2008, there were 266 potential candidates who underwent evaluation for living kidney donation in our center. Among the potential candidates, most were spouses (n=85, 31.9%), followed by parents (n=67, 25.1%), siblings (n=62, 23.3%), and children (n=40, 15%). Eventually, 124 candidates (47%) completed organ donation, most of whom were siblings (n=39, 31.5%), then parents (n=38, 30.6%), spouses (n=26), and children (n=18). Most donors were females, including mothers and sisters. The most frequent reason to not donate was unwillingness, due to potential influences on their health, economic stress due to suspension of their job, and objection of family members. In 34 candidates (23.9%), adverse health factors of potential candidates prohibited them from donating, including age, chronic medical illness, hepatitis carrier status, severe depression, or mental retardation. Among 59 potential donor-recipient pairs with incompatible ABO blood types or highly sensitized to potential donors, 22 candidates completed living kidney donation. Although laparoscopic nephrectomy for living kidney donation decreases the discomfort and hospital stay after donation, we can only promote living kidney donation if we can deal with the possible factors that prohibit candidates from living kidney donation, such as morbidity after organ donation, anxiety, or other factors. After analyzing those factors, we must also develop a protocol to closely follow the living kidney donors to ensure their health status and relieve their anxiety.
  Transplantation Proceedings 04/2010; 42(3):689-91. · 1.00 Impact Factor
• Article: Influence of UNOS status on chance of heart transplantation and posttransplant survival.

  C I Tsao, H Y Lin, M H Lin, W J Ko, R B Hsu, S L Hwang, S C Chen, N K Chou, H T Tu, Y S Chen, S S Wang
  [show abstract] [hide abstract]
  ABSTRACT: This study was designed to compare the chance of heart transplantation (HTx) and survival among patients in different UNOS statuses in Taiwan. METHODS AND RESULTS: From 1996 to 2002, among 203 patients on the heart transplant waiting list, 127 patients had undergone HTx up to December 2002 with 71 dead while waiting, and 5 still alive without transplantation. This study included those 198 patients who had either undergone HTx or who died. At the time of registry, 40 patients were at status IA, 57 at IB, and 101 at II. Nineteen (47.5%) of 40 status IA patients underwent HTx with a mean waiting time of 92 +/- 116 days and median waiting time of 35 days. The 1-month survival was 84%, and 1-year survival was 58%. Seven (64.9%) of 57 status IB patients underwent HTx with a mean waiting time of 85 +/- 100 days and a median waiting time of 40 days. Both 1-month and 1-year survivals were 92%. Seventy-one (70.3%) patients among 101 status II patients underwent HTx. Their mean waiting time was 134 +/- 135 days and median waiting time was 86 days. Their 1-month survival was 95%, and 1-year survival was 85%. CONCLUSION: Although UNOS status IA patients had a shorter waiting time, their chance to undergo HTx was lower than those in either status IB or status II. The UNOS status IA heart-waiting patients showed lower posttransplant 1-month and 1-year survival rates.
  Transplantation Proceedings 11/2004; 36(8):2369-70. · 1.00 Impact Factor
• Article: Surgical complications and outcome of living related liver transplantation.

  M-C Ho, Y-M Wu, R-H Hu, W-J Ko, Y-H Ni, M-H Chang, P-M Yang, M-Y Lai, M-H Lin, H-Y Lin, P-H Lee
  [show abstract] [hide abstract]
  ABSTRACT: Living donor liver transplantation (LDLT) is now widely performed for patients to resolve the critical shortage of organs from cadavers. Despite rapid implementation and expansion of the procedure, both outcome and complication analyses of LDLT are still incomplete. To analyze the outcome of LDLT, with particular reference to complications of those in need of surgical or radiological intervention. Forty-eight LDLTs performed at National Taiwan University Hospital between December 1997 and April 2003 were reviewed retrospectively. Forty-two (87.5%) patients survived the operation. The 1-year graft and patient survival rate was 81.5%. Seventeen of the 48 LDLT patients had at least one postoperative complication, which needed surgical or radiological intervention. The complications included bile leakage (n = 3), biliary stricture (n = 4), internal bleeding (n = 7), intra-abdominal abscess (n = 2), liver abscess (n = 1), hepatic artery thrombosis (n = 2), duodenal ulcer bleeding (n = 1), jejunal perforation (n = 1), adhesion ileus (n = 1), and intracranial hemorrhage (n = 1). Nine of the 17 patients with complications died. In contrast, only 2 of the other 31 patients died. Seven of the mortalities were related to the complications. All survivors received only one definite intervention early after the complications were diagnosed. However, the others received an average of 1.71 +/- 0.95 (0 to 3) interventions. Complications requiring surgical or radiological treatment caused major mortality of LDLT. Early and definite treatment of these complications is important to improve the patient's outcome.
  Transplantation Proceedings 11/2004; 36(8):2249-51. · 1.00 Impact Factor
• Article: Do patients with acute liver failure have a better chance to receive liver grafting?

  M H Lin, H Y Lin, C I Tsao, W J Ko, S L Hwang, R H Hu, M C Ho, Y M Wu, S C Chen, P H Lee
  [show abstract] [hide abstract]
  ABSTRACT: Patients with acute hepatic failure (AHF) were always given first priority on the transplant waiting list. We investigated whether AHF patients will deprive other patients on the waiting list of the chance of liver transplantation (LTx). From January 1999 to March 2003, a total of 423 patients were on the transplant waiting list at the National Taiwan University Hospital. Sixty-five of the patients had AHF caused by hepatitis-B-related disease (HBV, n = 52, 80%), Wilson disease (n = 3, 4.6%), drug-induced AHF (n = 3, 4.6%), and other causes (n = 7, 10.8%).Thirty-three patients died and 16 survived by medical treatment. Two received LTx abroad and 14 underwent LTx at our hospital (7 living-related; 7 cadaver). A total of 140 patients died while waiting for a transplant during the period studied. Of them, 107 were among 358 non-AHF patients (30%), and time-to-death interval was 133 +/- 175 days (median: 62); 33 were among 65 AHF patients (51%); time to death was 19 +/- 28 days (median: 8). There were 35 cadaver donor livers available during the period; 28 of 358 non-AHF patients (7.8%), and 7 of 65 AHF patients (10.7%) received cadaveric LTx. Their waiting time totaled 342 +/- 316 and 12 +/- 9 days, respectively (P < .0001). Most AHF patients died unless they received liver grafts. Even with a higher priority assigned to them, AHF patients still have little chance to get a cadaver donor liver in Taiwan, and non-AHF patients have an even slimmer chance. Therefore, we need to encourage liver donation from living-related donors.
  Transplantation Proceedings 10/2004; 36(8):2232-3. · 1.00 Impact Factor
• Article: Liver transplantation for patients with hepatocellular carcinoma.

  M-C Ho, Y-M Wu, R-H Hu, W-J Ko, P-M Yang, M-Y Lai, M-H Lin, H-Y Lin, P-H Lee
  [show abstract] [hide abstract]
  ABSTRACT: Liver transplantation (LT) has been advocated as a salvage treatment for unresectable hepatocellular carcinoma (HCC). Selection criteria still need to be developed in Taiwan. The purpose of our study was to assess the clinical findings and outcome of cirrhotic patients with HCC undergoing liver transplantation. Our study consisted of 13 HCC patients who underwent liver transplantation during October 1996 to March 2003. The medical records and pathologic reports were analyzed retrospectively. Overall survival rates at 1 and 3 years were 86% and 61%, respectively. HCC recurrences occurred in three patients, one of whom is still alive with HCC recurrence 2 years after LT. The other two patients died of HCC recurrence 1 and 2 years after LT, respectively. Pretransplant alpha-fetoprotein (AFP) levels of >200 ng/mL were noted in all three patients with HCC recurrence. In contrast, only one of the ten patients without HCC recurrence had pretransplant AFP >200 ng/mL (P = .003). Four patients did not meet Milan criteria, two of whom had HCC recurrence. However, the other two patients with microscopic vascular invasion survived and were free of HCC. The only one patient, who had histologic grade 4 HCC, died of recurrence, although his tumor was AJCC stage 1. High AFP level is a risk factor for HCC recurrence after LT. In addition to Milan criteria, histologic tumor grading should be considered in patient selection. Microscopic vascular invasion may not affect the outcome of the patients with early HCC.
  Transplantation Proceedings 10/2004; 36(8):2291-2. · 1.00 Impact Factor
• Article: Impact of renal transplantation on sexual function in female recipients.

  Y Chen, S-H Chu, M-H Lin, Y-J Chiang, C-K Chuang
  Transplantation Proceedings 03/2003; 35(1):313-4. · 1.00 Impact Factor
• Article: The context framing the changes in health-related quality of life and working competence before and after lung transplantation: one-year follow-up in Taiwan.

  F-J Shih, Chuan-I Tsao, M H Lin, H Y Lin
  Transplantation Proceedings 12/2002; 34(7):2801-6. · 1.00 Impact Factor
• Article: The dilemma of "to-be or not-to-be": needs and expectations of the Taiwanese cadaveric organ donor families during the pre-donation transition.

  F J Shih, M K Lai, M H Lin, H Y Lin, C I Tsao, B R Duh, S H Chu
  [show abstract] [hide abstract]
  ABSTRACT: There has been little study of the Chinese cadaveric donor family's decisions to donate organs within the Chinese cultural framework. A convenience sample of 25 cadaveric donor family members (12 men, 13 women) who gave their consent to donation at National Taiwan University Hospital agreed to participate in this study and completed in-depth interviews. Data were analyzed by a three-steps within-method qualitative triangulation method. The factors influencing the donor family's decisions to donate organs, the needs of donor families, and their expectations of health care providers during the pre-donation transition--the critical period of time between signing a donation and consent to organ harvesting--were examined. The background context and a conceptual framework were further developed to discuss and depict this phenomenon. This project aims to broaden the horizon on organ donation and contribute to the understanding of some of the psychodynamic issues in the Chinese family in Taiwan.
  Social Science [?] Medicine 10/2001; 53(6):693-706. · 2.70 Impact Factor
• Article: Changes in health-related quality of life and working competence before and after liver transplantation.

  F J Shih, R H Hu, M C Ho, H Y Lin, M H Lin, P H Lee
  Transplantation Proceedings 12/2000; 32(7):2144-8. · 1.00 Impact Factor
• Article: Family perspectives of the factors facilitating Taiwanese pediatric recipients' recovery from liver transplantation: one year follow-up.

  F J Shih, R H Hu, M C Ho, M H Lin, H Y Lin, C E Tao, Y L Lee, P H Lee
  Transplantation Proceedings 12/2000; 32(7):2152-5. · 1.00 Impact Factor
• Article: An analysis of status of cadaver donors at The National Taiwan University Hospital: eleven-year case review.

  W J Ko, M H Lin, H Y Lin, C I Tsao, P H Lee
  Transplantation Proceedings 12/2000; 32(7):1569. · 1.00 Impact Factor
• Article: Analysis of the renal transplant waiting list at the National Taiwan University Hospital: eleven-year case review.

  W J Ko, H Y Lin, M H Lin, C I Tsao, F J Shih, P H Lee
  Transplantation Proceedings 12/2000; 32(7):1589-90. · 1.00 Impact Factor
• Source

  Available from: ntu.edu.tw

  Article: Changes in quality of life and working capacity before and after kidney transplantation.

  F J Shih, P H Lee, J D Wang, R H Hu, M K Lai, H Y Lin, M H Lin, C J Lee
  Transplantation Proceedings 09/1999; 31(5):1981-4. · 1.00 Impact Factor
• Article: The degree of recovery from kidney transplantation before discharge from the hospital: Taiwanese patient's perspective.

  F J Shih, M H Lin, H Y Lin, C J Lee
  Transplantation Proceedings 12/1998; 30(7):3639-42. · 1.00 Impact Factor
• Article: Impact of cadaveric organ donation on Taiwanese donor families during the first 6 months after donation.

  F J Shih, M K Lai, M H Lin, H Y Lin, C I Tsao, L L Chou, S H Chu
  [show abstract] [hide abstract]
  ABSTRACT: Organ donation is a complex decision for family members of Asian donors. The impact of cadaveric organ donation on both Chinese and Western donor families has not been well investigated within a cultural framework. The purposes of this study were to follow Chinese family members' appraisal of their decision to donate organs, to explore the possible negative and positive impacts of organ donation on their family life, and to determine what help they expected from healthcare providers during the first 6 months after donation. Twenty-two family members (10 men and 12 women) of cadaveric organ donors who signed consent forms at an organ transplant medical center in Taiwan participated in this project and completed in-depth interviews during the sixth month after donation. Participants were 25 to 56 years old (mean = 48.15 +/- 8.31 years). The type of kinship of the participants included the donor's parents, older sister, and spouse. Subjects reported several negative impacts: worry about the donor's afterlife (86%), stress due to controversy among family members over the decision to donate (77%), and stress due to others' devaluation of the donation (45%). Positive impacts reported by the subjects included having a sense of reward for helping others (36%), having an increased appreciation of life (32%), having closer family relationships (23%), and planning to shift life goals to the study of medicine (9%). Subjects expected the transplant team to provide information about organ recipients (73%), to submit the necessary documents so that family members could receive healthcare payments from the insurance company (68%), to help resolve legal proceedings and settlements associated with accidents (64%), and to not overly publicize their decision to donate (64%). Although all of the subjects reported that organ donation was the right decision, the decision to donate did not protect Taiwanese donor families from negative psychocognitive bereavement. The impacts of organ donation were affected by the subject's social cultural, spiritual, and legal context and the nature of their bereavement.
  Psychosomatic Medicine 63(1):69-78. · 3.97 Impact Factor
• Article: Analysis of the Factors Influencing Living Kidney Donation: The Experience in National Taiwan University Hospital

  M.H. Lin, M.K. Tasi, H.Y. Lin, C.H. Lee, S.C. Chen, P.H. Lee
  [show abstract] [hide abstract]
  ABSTRACT: IntroductionKidney transplantation provides a choice of active treatment for patients with chronic renal failure. However, the sources of organs are limited; therefore, living kidney donation is an alternative source. The regulation of organ donation in Taiwan stipulates that living organ donation is restricted to living related recipients. We sought to investigate factors that influenced or prevented individuals from living kidney donation in our center.Materials and methodsFrom January 2005 to December 2008, there were 266 potential candidates who underwent evaluation for living kidney donation in our center.ResultsAmong the potential candidates, most were spouses (n = 85, 31.9%), followed by parents (n = 67, 25.1%), siblings (n = 62, 23.3%), and children (n = 40, 15%). Eventually, 124 candidates (47%) completed organ donation, most of whom were siblings (n = 39, 31.5%), then parents (n = 38, 30.6%), spouses (n = 26), and children (n = 18). Most donors were females, including mothers and sisters. The most frequent reason to not donate was unwillingness, due to potential influences on their health, economic stress due to suspension of their job, and objection of family members. In 34 candidates (23.9%), adverse health factors of potential candidates prohibited them from donating, including age, chronic medical illness, hepatitis carrier status, severe depression, or mental retardation. Among 59 potential donor-recipient pairs with incompatible ABO blood types or highly sensitized to potential donors, 22 candidates completed living kidney donation.ConclusionAlthough laparoscopic nephrectomy for living kidney donation decreases the discomfort and hospital stay after donation, we can only promote living kidney donation if we can deal with the possible factors that prohibit candidates from living kidney donation, such as morbidity after organ donation, anxiety, or other factors. After analyzing those factors, we must also develop a protocol to closely follow the living kidney donors to ensure their health status and relieve their anxiety.
  Transplantation Proceedings.