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Original Article

J Korean Soc Transplant 2018; 32(1): 7-11

Published online March 31, 2018

https://doi.org/10.4285/jkstn.2018.32.1.7

© The Korean Society for Transplantation

Comparison Study of Outcomes of Deceased Donor Liver Transplantation before and after Korean Model for End-Stage Liver Disease (MELD) System: Single Center Experience

Ji A Lee, M.D., Gyu-seong Choi, M.D., Jong Man Kim, M.D., Chun Hyuck David Kwon, M.D. and Jae-Won Joh, M.D.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to: Gyu-seong Choi
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: 82-2-3410-0410, Fax: 82-2-3410-1175
E-mail: med9370@gmail.com

Received: October 17, 2017; Revised: March 6, 2018; Accepted: March 8, 2018

Abstract

Background: In June of 2016, the Model for End-Stage Liver Disease (MELD)-based allocation system replaced the Child-Turcotte-Pugh (CTP) score-based system for deceased donor liver transplantation (DDLT) in Korea. This study was conducted to reveal the changes before and after the MELD system.
Methods: From January 2015 to March 2017, 71 patient datapoints were collected from recipients who underwent DDLT in a single center. Patients were divided into two groups according to the allocation system (41 in the MELD group, 30 in the CTP group).
Results: The MELD score of the two groups differed significantly (36.8±4.5 in the MELD group, 26.0±8.1 in the CTP group, P=0.001). There was no difference in etiology for liver transplantation, 6-month survival rate, or in-hospital stay. However, complication rate and re-admission rate within the first 3 months were higher in the MELD group (78%, 56%). No one received a DDLT because of an incentive system for hepatocellular carcinoma.
Conclusions: Despite the short-term follow-up period, the new allocation rule reflects the severity of the patients. Almost all patients who underwent DDLT when they had a high MELD score and then suffered from morbidity; however, this problem was associated with organ shortage, not the allocation system.

Keywords: Liver transplantation, Model for End-Stage Liver Disease, Allocation