Korean J Transplant.  2022 Nov;36(Supple 1):S180. 10.4285/ATW2022.F-3060.

Medical accessibility and outcomes in liver transplantation

• Jo SJ
• Rhu J
• Joh JW
• Kim JM
• Choi Gs

• KMID: 2535696
• DOI: http://doi.org/10.4285/ATW2022.F-3060

Abstract

Background
Medical accessibility is important in liver transplantation (LT) because of the risk of infections due to the use of immunosuppressant and complications that require continuous treatment such as biliary stenosis. However, there are no evidence on the effect of medical accessibility and LT. The aim of this study is to investigate whether medical accessibility affects the outcome of LT.
Methods
For this retrospective observational study, we enrolled patients who had undergone LT at the Samsung Medical Center between January 2017 and December 2021. Medical accessibility was divided into two groups (hard and easy) and the criterion was the time (120 minutes) taken by public transportation. Basal characteristics were calibrated with propensity score matching (PSM). The outcomes (overall survival [OS] and graft survival) and the severity of emergency center visits according to medical accessibility were investigated.
Results
A total of 486 patients were included in this study. The median time taken by public transportation was 135 minutes. The variables included sex, Child-Pugh classification, model for end-stage liver disease, presence of hepatocellular carcinoma, and donor type were calibrated with PSM and each group consisted of 217 patients. The OS (87% vs. 86.7%, P=0.649) and graft survival (97.7% vs. 96.1%, P=0.35) showed no significant differences between the hard and the easy groups. In the severity of emergency center visits, the hard group (27.2%) demonstrated more severe than easy group (17.1%), but it was not statistically significant.
Conclusions
Medical accessibility in LT did tend to increase emergency center severity, but did not affect long-term outcomes.