Korean J Transplant.  2022 Nov;36(Supple 1):S389. 10.4285/ATW2022.F-5270.

A study on differences in deceased donor liver transplantation before and after the introduction of the model for end-stage liver disease system: three low volume centers, multi-center trial

• Lee TY

• KMID: 2535215
• DOI: http://doi.org/10.4285/ATW2022.F-5270

Abstract

Background
The shortage of donor organs in transplantation is the biggest obstacle to organ transplantation. From June 1, 2016, the Korean organ transplant standard was converted to the model for end-stage liver disease (MELD) system. This study aims to clarify the differences in deceased donor liver transplantation before and after the introduction of the MELD system in three low volume centers in the Gyeongin area.
Methods
From June 2013 to May 2019, the study was conducted retrospectively with adult patients undergoing deceased do- nor liver transplantation at Incheon St. Mary hospital, Soonchunhyang University Bucheon Hospital, Gil Medical Center. Of the 431 registered patients, a total of 87 patients who underwent deceased donor liver transplantation (DDLT) were studied. Before June 2016 (before the MELD system) was designated as the Child-Turcotte-Pugh (CTP) group, and later as the MELD group. Fi-nally, the CTP group was 39 patients, and the MELD group was 48 patients.
Results
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Conclusions
Before the MELD system was introduced, liver transplantation due to hepatitis B virus (HBV) was the most com-mon, but after the MELD system, alcoholic liver disease was the most common primary disease. After the introduction of the MELD system, the waiting period for transplantation was shortened. As a cause for this; (A) with the introduction of the MELD system, DDLT is being conducted to more critical ill patients. Therefore, long waiting days for these patients lead to expired in many cases. (B) Alcohol-induced liver failure has increased, which is more worse prognosis than HBV or hepatitis C virus, re-sulting in shorter waiting days for transplantation. (C) There was no statistically significant difference in hospitalization period and survival rate between the two groups. On this study, the introduction of the MELD system can be considered the advantage of being more distributed to critical, severe patients.