Ann Surg Treat Res.  2021 Dec;101(6):360-367. 10.4174/astr.2021.101.6.360.

The impact of Model for End-Stage Liver Disease score on deceased donor liver transplant outcomes in low volume liver transplantation center: a retrospective and singlecenter study

• Lee DH
• Park YH
• Choi SW
• Nam KH
• Choi ST
• Kim D

• KMID: 2522935
• DOI: http://doi.org/10.4174/astr.2021.101.6.360

Abstract

Purpose
In June 2016, the Model for End-Stage Liver Disease (MELD) score was employed in South Korea instead of the Child-Turcotte-Pugh (CTP) score. This study compared the outcomes of deceased donor liver transplantation (DDLT) before and after the MELD system application.
Methods
This retrospective study reviewed 48 patients who underwent DDLT for end-stage liver disease at a single tertiary referral center between January 2014 and December 2018. The patients were categorized into the pre-MELD (22 patients) and post-MELD (26 patients) groups. The demographics, postoperative outcomes, and overall survival time were evaluated between the 2 groups.
Results
The 2 groups had no differences in age, sex, ABO type, etiology for liver transplantation, CTP-score, operation time, cold ischemic time, and amount of red blood cell transfusion, although their MELD score differed significantly (postMELD group, 36.2 ± 4.9; pre-MELD group, 27.7 ± 11.8; P < 0.001). The post-MELD group has longer intensive care unit stay (11.2 ± 9.5 days vs. 5.7 ± 4.5 days, P = 0.018) and hospital stay than the pre-MELD group (36.8 ± 26 days vs. 22.8 ± 9.3 days, P = 0.016). The 1-year survival rate was lower in the post-MELD group (61.5% vs. 86.4%, P = 0.029).
Conclusion
After MELD allocation, patients with high MELD scores had increased DDLT and consequently required a longer recovery time, which could negatively affect survival. According to the experience of a small-volume center, these problems were related to both severe organ shortages in South Korea and MELD allocation.

Keyword

Alcoholic fatty liver; Liver cirrhosis; Liver transplantation; Model for End-Stage Liver Disease; Morbidity

Figure

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  Fig. 1 Kaplan-Meier curve for overall survival between the 2 groups. MELD, Model for End-Stage Liver Disease.

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  Fig. 2 Kaplan-Meier curve for 12-month survival between the 2 groups. MELD, Model for End-Stage Liver Disease.

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