Ann Liver Transplant.  2021 May;1(1):10-17. 10.52604/alt.21.0003.

Absence of influence of the Korean MELD score-based liver allocation system on pretransplant MELD score in patients undergoing living donor liver transplantation

• Kim SH
• Hwang S
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Kim KH
• Yoon YI
• Kang WH
• Cho HD
• Kim M
• Na BG
• Kim SM
• Yang G
• Lee SG

• KMID: 2560848
• DOI: http://doi.org/10.52604/alt.21.0003

Abstract

Background
Model for end-stage liver disease (MELD) score-based allocation system was started in 2016 in Korea. This study aimed to analyze the profiles of adult patients who underwent living donor liver transplantation (LDLT) in the pre- and post-MELD eras.
Methods
This study was a retrospective double-arm analysis using a single-institution LDLT cohort. We compared the LDLT recipient profiles by focusing on pretransplant MELD score for 4 years before and after the introduction of the MELD scorebased allocation system. Patients without and with hepatocellular carcinoma (HCC) were categorized as Group A and B in the pre-MELD era and Group C and D in the post-MELD era, respectively.
Results
The number of patients in Groups A, B, C and D was 615, 599, 704 and 713, respectively; and their MELD scores were 19.0±9.4, 11.2±5.6, 17.9±8.5 and 11.6±5.7, respectively. Clinical parameters of liver cirrhosis indicate that Group A had worse general conditions than Group C; and Groups B and D had similar general conditions. The comparative analysis between Groups A and C revealed the mean and median MELD scores as 19.0±9.4 and 17.9±8.5 (p=0.009), and 16 and 15 (p=0.077), respectively. The comparative analysis between Groups B and D revealed the mean and median MELD scores as 11.2±5.6 and 11.6±5.7 (p=0.14), and 9 and 9 (p=0.14), respectively.
Conclusion
Median pretransplant MELD score was in the range of 15-16 in LDLT recipients without HCC and 9 in those with HCC. Introduction of MELD score in deceased donor organ allocation system resulted in a marginal decrease in the pretransplant MELD score in patients undergoing LDLT without HCC, but no change in those with HCC.

Keyword

MELD score; Hepatocellular carcinoma; Living donor; Deceased donor; Organ allocation