Korean J Transplant.  2022 Nov;36(Supple 1):S30. 10.4285/ATW2022.F-1262.

Deceased donor liver transplantation under Korean MELD score-based liver allocation system at a high-volume transplantation center

• Hong JJ
• Kim NG
• Hwang S

• KMID: 2535178
• DOI: http://doi.org/10.4285/ATW2022.F-1262

Abstract

Background
The Korean model for end-stage liver disease (MELD) score-based liver allocation system started in June 2016 in Korea.
Methods
This study analyzed the detailed status of deceased donor liver transplantation (DDLT) after implementation of the MELD score-based liver allocation system at a high-volume liver transplantation (LT) center in Korea.
Results
The study patients were 432 patients with age greater than 14 years. Their ABO blood groups were A (n=158, 36.7%), B (n=104, 24.0%), O (n=90, 20.8%), and AB (n=80, 18.5%). Types of LT were primary LT in 344 (79.6%) and retransplantation in 88 (20.4%). Their KONOS statuses at LT were status 1 (n=21, 4.9%), status 2 (n=260, 60.2%), status 3 (n=133, 30.8%), and status 4 (n=18, 4.1%). Mean MELD score at LT and waiting period were 37.0 and 80.4 days in blood group A; 37.0 and 44.4 days in blood group B; 39.0 and 73.2 days in blood group O; and 34.0 and 87.3 days in blood group AB. Blood group O and AB patients had the highest and lowest mean MELD score at LT allocation, respectively.
Conclusions
Serious deceased organ donor shortage led to make a deleterious cycle in raising the MELD score cutoff of LT al-location. Blood group O and AB patients had disadvantage and advantage in LT allocation due to ABO blood group compatibility. High-volume multicenter or nationwide follow-up studies are necessary to precisely delineate the allocation status of DDLT.