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

Doo-Ho Lee; Yeon Ho Park; Seok Won Choi; Kug Hyun Nam; Sang Tae Choi; Doojin Kim

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자료유형: 학술저널

저자정보: Doo-Ho Lee (Gachon University College of Medicine) Yeon Ho Park (Gachon University College of Medicine) Seok Won Choi (Gachon University College of Medicine) Kug Hyun Nam (Gachon University College of Medicine) Sang Tae Choi (Gachon University College of Medicine) Doojin Kim (Gachon University College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.101 No.6

발행연도: 2021.12

수록면: 360 - 367 (8page)

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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 (post-MELD 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.

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

참고문헌 (17)

참고문헌 신청

홍근 / 2013 / The Model for End-Stage Liver Disease Score-Based System Predicts Short Term Mortality Better Than the Current Child-Turcotte-Pugh Score-Based Allocation System during Waiting for Deceased Liver Transplantation / Journal of Korean Medical Science 28(8):1207~1212

Min SI / 2015 / To achieve national self sufficiency: recent progresses in deceased donation in Korea / Transplantation 99:765~770

Malinchoc M / 2000 / A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts / Hepatology 31:864~871

김명수 / 2016 / 간장 응급도 기준 개선방안 연구: 한국형 멜드시스템의 학술적 배경 / Korean Journal of Transplantation 30(2):51~58

Dutkowski P / 2011 / The model for end-stage liver disease allocation system for liver transplantation saves lives, but increases morbidity and cost: a prospective outcome analysis / Liver Transpl 17:674~684

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