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KMID : 0870420170210040199
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2017 Volume.21 No. 4 p.199 ~ p.204
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Successful introduction of Model for End-stage Liver Disease scoring in deceased donor liver transplantation in Korea: analysis of first 1 year experience at a high-volume transplantation center
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Ha Soo-Min
Hwang Shin
Song Gi-Won
Ahn Chul-Soo
Moon Deok-Bog
Ha Tae-Yong
Jung Dong-Hwan
Park Gil-Chun
Kim Ki-Hun
Kim Dae-Yeon
Namgung Jung-Man
Kang Woo-Hyoung
Kim Seok-Hwan
Jwa Eun-Kyoung
Kwon Jae-Hyeon
Cho Hui-Dong
Jung Yong-Kyu
Kang Sang-Hyeon
Lee Sung-Gyu
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Abstract
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Backgrounds/Aims: Model for End-stage Liver Disease (MELD) score was adopted in June 2016 in Korea.
Methods:We analyzed changes in volumes and outcomes of deceased donor liver transplantation (DDLT) for 1 year before and after introduction of MELD scoring at Asan Medical Center.
Results: There were 64 cases of DDLT in 1 year before MELD introduction and 106 in 1 year after MELD introduction, an increase of 65%. The volume of DDLTs abruptly increased during first 3 months, but then returned to its usual level before MELD introduction, which indicated 3-month depletion of accumulated recipient pool with high MELD scores. The number of pediatric DDLT cases increased from 3 before MELD introduction to 11 after it, making up 21.4% and 47.8% of all cases of pediatric liver transplantation, respectively. The number of cases of retransplanted DDLTs increased from 4 to 27, representing 6.3% and 25.5% of all DDLT cases, respectively. The number of status 1 DDLT cases increased from 5 to 12, being 7.8% and 11.3% of all cases. Patient survival outcomes were similar before and after MELD introduction.
Conclusions: The number of DDLTs temporarily increased after adoption of MELD scoring due to accumulated recipient pool with high MELD scores. The numbers of retransplanted and pediatric DDLT cases significantly increased. Patient survival in adult and pediatric DDLT was comparable before and after adoption of MELD scoring. These results imply that Korean MELD score-based allocation system was successfully established within its first year. (Ann Hepatobiliary Pancreat Surg 2017;21:199-204)
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KEYWORD
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Liver transplantation, MELD score, Survival
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