J Korean Soc Transplant.  2018 Mar;32(1):7-11. 10.4285/jkstn.2018.32.1.7.

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

• Lee JA
• Choi GS
• Kim JM
• Kwon CH
• Joh JW

• KMID: 2408662
• DOI: http://doi.org/10.4285/jkstn.2018.32.1.7

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.

Keyword

Liver transplantation; Model for End-Stage Liver Disease; Allocation

MeSH Terms

Carcinoma, Hepatocellular
Cytidine Triphosphate
Follow-Up Studies
Humans
Korea
Liver Diseases*
Liver Transplantation*
Liver*
Motivation
Survival Rate
Tissue Donors*
Cytidine Triphosphate

Figure

• 

  Fig. 1. Six month-survival curve of two groups. Dashed line is a Model for End-Stage Liver Disease (MELD) group, and dot line a Child-Turcotte-Pugh (CTP) groups. No difference between two groups was shown statistically (MELD group 82.9%, CTP group 80.8%, P=0.338).

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