At the request of the national government, the Hepatitis Information Center has been holding educational workshops for laboratory technicians, nurses, physicians, and social workers in the liver disease information center since 2011. The Workshop participants (n=190) between 2012 and 2015 submitted, in advance, a report on the problems that they had faced in their daily work. According to qualitative content analysis and text mining analysis (KH-Coder), the following results have been found:

1. Problems regarding the consultation system.

2. Insufficient support to hepatitis patients and their families due to a lack of consultation skills.

3. Problems acquiring the latest information and knowledge.

4. Lack of opportunities for knowledge sharing.

In order to provide more effective consultation, it is necessary to develop comprehensive programs that will ensure that all staff members, regardless of position, length of service or status, can acquire the latest information and skills.

A 72-year-old male was observed to have elevated liver enzymes. Therefore, he underwent computed tomography (CT), which identified a mass on his liver. The lesion was located in S6, and its size was 47×36 mm. On enhanced ultrasonography, the lesion was hypervascular in the arterial phase and appeared as a defect in the post-vascular phase (Kupffer phase). Furthermore, penetrating vessels (portal vein) were detected in the tumor by enhanced ultrasonography. On CT, the lesion was low in the plain phase and was enhanced in the enhanced phase. On magnetic resonance imaging, the lesion had an Iso signal, a High signal, was enhanced, and appeared as a defect on T1WI, T2WI, EOB arterial phase, and EOB hepatocyte phase, respectively. It was diagnosed as mucosa-associated lymphoid tissue by tumor biopsy. The accumulation of ¹⁸F-FDG was not detected in other organs by PET/CT. Therefore, we diagnosed the lesion as mucosa-associated lymphoid tissue lymphoma of the liver. The patient had a complete response to chemotherapy and has remained alive for 24 months.

A 48-year-old man with liver dysfunction was referred to our hospital and was hospitalized for diagnosis in March 2016. He had been pointed our liver dysfunction since 2006 and liver biopsy was performed in another hospital in October 2014, but the cause of liver dysfunction was unknown. His liver biopsy tissue showed significant bile plugs in the expanded bile ducts. Notably, progression of hepatic fibrosis was demonstrated in comparison with the liver tissue obtained 1 year and 5 months ago. We recognized that he had had skin sunlight hypersensitivity from early childhood by focused history taking. Then we examined protoporphyrin in his red blood cells and conducted genetic test, and diagnosed him as erythropoietic protoporphyria (EPP). In spite of the risk of development to liver cirrhosis, there is no curative therapy for EPP at this time and it was thought that thorough shading is necessary. This EPP case is considered valuable because the serial changes in the liver tissue were observed.

There are few reports of the results of sorafenib therapy for a sarcomatoid hepatocellular carcinoma (s-HCC). We treated a 72-year-old Japanese man who had previously undergone resection of s-HCC. Epigastric pain and anorexia were present, thus abdominal ultrasonography was performed as screening and a liver tumor (6 cm in diameter) was found in the 6th segment of the liver. The patient had diabetes mellitus (HbA1c 8.8%), but no chronic viral hepatitis. The tumor was diagnosed as s-HCC based on pathological results. Multiple extrahepatic metastases (lymph node, adrenal) were detected 5 months after the resection procedure. Sorafenib therapy was introduced and the tumors were controlled as stable disease (SD) for 20 months. Sorafenib treatment may be effective for patients with s-HCC.

The medical staff of Okayama University Hospital visited workplaces and held the seminars on viral hepatitis, such as precaution against viral infection at workplaces, necessity of hepatitis virus screening tests, and drastic improvement of hepatitis treatment. Concurrent hepatitis virus screening tests on site of the seminars were also provided, and as many as 94.1% of the participants took the tests. The feedback of the seminars at workplaces showed that the seminars should be very helpful to correct prejudice and misunderstanding against viral infection. Hepatitis seminars at workplace and concurrent hepatitis virus screening test on site can be an efficient strategy for finding out latent hepatitis patients with supportive environment at workplace in case of hepatitis treatments.

The distribution of hepatitis C virus (HCV) genotype was investigated based on patient's birth year in 405 HCV-infected patients in a city hospital in Mito, Japan. The proportion of HCV genotype 1b (HCV-1b) decreased gradually and became <50% in patients born after 1960. Among 174 patients who were assumed to have contracted HCV infection during 1952-2005, 90 (71%) of 127 patients with a history of blood transfusion/surgery had HCV-1b. Notably, in patients with intravenous drug use (IVDU) or piercing, dominant HCV genotype changed from 1b (67%, 8/12) to 2a/2b (86%, 12/14) after 1980. Despite the virtually null risk of transfusion-transmitted HCV infection, residual risk of HCV infections via non-iatrogenic routes such as IVDU and piercing should continuously be surveyed.

The rate of donation from deceased persons per million populations in Korea has been increasing to 8.0 in 2013. The number of DDLT (deceased donor liver transplantation) reached 456 in 2015 (32.7% of whole LT). Now, Korea is one of Asian countries with the highest organ donation rate.

There are many factors influencing the donation rate, such as socio-legal system such as Korean Network for Organ Sharing (KONOS) and Korean Organ Donation Agency (KODA), health-care system, and public awareness. Korea temporarily decreased number of donation after adoption of nationwide organ allocation system in 2000.

To increase public awareness is more important and should be parallel. Public awareness are affected by several reasons; 1) belief (fear of bodily harm), 2) Familyism culture, and 3) low level of understanding about brain death & deceased organ donation. Korean transplant society and government has been doing several actions to increase public awareness.