Lee Sung-gyu
Professor in Department of Surgery, University of Ulsan College of Medicine
Lee Sung-gyu, one of the most reputable and prolific liver transplant surgeons in the world, has performed more than 6,000 liver transplant operations, including 5,000 using liver from living donors. Over the past decade, he has trained surgeons in other parts of Asia, including Vietnam and Mongolia.
James Eason, the renowned doctor who helped extend Steve Jobs’ life by over two years with a liver transplant in 2009, visited Lee Sung-gyu at Asan Medical Center in Seoul in 2015. The purpose of his visit was to learn from the hospital’s liver transplant team, which is building its reputation as one of the world’s best, if not the best. And apparently, the American surgeon learned much during his two-week visit there. After returning to Memphis, Tenn., he sent an email to Lee, 66, the team leader and the director-general at Asan, saying, “I had an amazing experience at Asan. You have developed one of the world’s best transplant programs and an exceptional team. I learned from every person on your team.” Eason’s visit and message are an indication of how far Korea has come in the field of liver transplantation. Only 30 years ago, patients with a serious liver illness here had to go to countries such as Germany, Japan and the United States to get a liver transplant. Today, an increasing number of patients and doctors from around the world come here for treatment and training, respectively. “The annual number of living-donor liver transplant cases at Asan alone is over 300. We perform more liver transplant operations (annually) than all U.S. hospitals combined,” Lee said. “Also, our success rate is among the world’s highest at 96 percent, far higher than the U.S. average of 88 percent. This has been achieved despite the fact that 20 to 25 percent of our patient population is critically ill.” Lee has so far performed more than 4,000 liver transplant operations, using liver mainly from living donors, not from brain-dead ones. And despite the large number of liver transplant surgeries he performs, none of his living donors have died or suffered from serious complications as a result of the operation.
“What we have proved here is the absolute safety of donors. That’s one of the things that we are very proud of,” Lee said. “Among all Korean hospitals, only one donor has died since the nation’s first successful human liver transplant in 1988.” According to organdonor.gov, a website of the U.S. Department of Health and Human Services, two out of every 1,000 liver donors die as a result of the surgery. When Thomas Starzl performed the first successful human liver transplant in 1967, few Koreans understood what the operation meant. But, times have clearly changed. The list of Lee’s accomplishments goes on. In 1999, to solve problems in blood flow during surgery, a critical factor in the survival rate of liver transplant recipients, he used a modified right lobe graft — the first doctor in the world to do so. “I came up with the method after some patients with a serious liver illness died of blood flow issues. Simply put, it gives the patient additional vein to promote blood circulation,” Lee said. The following year, he achieved another breakthrough, successfully performing a liver transplant by using dual left lobe grafts from two different donors. Lee said the new method helps overcome the small-for-size syndrome, in which the recipient develops a liver dysfunction because the donated liver is too small, and ensure donor safety. “Thanks to the new method, surgery became safer. Now, more patients and donors can be treated with far less health risks,” he said.
Asan in Asia Project
Over the past five years, the Asan Foundation has been providing free medical training and equipment to doctors in other countries, including Mongolia and Vietnam. On Feb. 22, 2014, a four-year-old Mongolian patient with cirrhosis, a disease that destroys normal liver cells, got a
second chance at life after receiving a liver transplant in his country. Thanks to the Asan in Asia Project, which was launched in 2010 to help raise medical standards in the region, Mongolian doctors learned how to perform a liver transplant from Lee’s team. The child’s surgery was a successful result of the training. “It’s time for Korea to help,” Lee said. “And the best way to help other countries is to teach them how to treat their patients rather than just to provide medicines.”
Dreaming of becoming a doctor
From his own experience, Lee truly understands how important his team’s efforts are.
When he was six years old, he suffered from constrictive pericarditis, a disease that impedes the diastolic function of the heart. “I was told that no doctor in Korea could cure the disease. But luckily, thanks to help from my uncle in Japan, I got surgery at the University of Tokyo Hospital,” he said. “I was the first patient ever to get the surgery there. I was really lucky.” His younger sister, however, was not as fortunate. When she was six years old, she died of tuberculous peritonitis. “She would have recovered, had she gotten early and proper treatment. But the first doctor she met was a bad one with little expertise. By the time she was moved to a bigger hospital, it was too late,” he said. When Lee entered Seoul National University to study medicine, his goal was to become a cardiothoracic surgeon because of his experience in Japan, he said. He had never thought about specializing in liver transplantation until he met his teacher Min Byung-cheol, the first Korean member of the American Board of Surgery. “He was a great but very strict teacher. After I graduated from medical school, he offered me a job at the New England Hospital he opened in Seoul. But I started working at a children’s hospital just to avoid him. I planned to work there for a while and then study abroad,” Lee said. “But two months later, I realized that I should stop wasting my time there. I knew that I needed to learn more.” At Min’s hospital, Lee trained for five years as surgeon. “I was yelled at for every mistake. It wasn’t easy to learn from him. But looking back, I grew a lot as doctor during that period,” Lee said. Min believed transplant surgery is the future of the medicine and planted the vision in Lee. It was the mid-1980s. Lee went to the United States, Japan and Germany to learn about liver transplants. During his years overseas, he met many good teachers such as Masatoshi Makuuchi at the National Cancer Center in Japan. He also experienced hard times, like when he ate a one-dollar hotdog on a Boston street for lunch because he could not afford a five-dollar meal at the cafeteria. There were also some doctors who didn’t treat him with respect, Lee recalled. “But it turned out every effort and hardship was worth it,” he said. “In retrospect, the people around me, including Min, Makuuchi and my wife, somehow guided me to where I am today. I just played my part.”