Ann Hepatobiliary Pancreat Surg.  2017 Nov;21(4):199-204. 10.14701/ahbps.2017.21.4.199.

Successful introduction of Model for End-stage Liver Disease scoring in deceased donor liver transplantation in Korea: analysis of first 1 year experience at a high-volume transplantation center

• Ha SM
• Hwang S
• Song GW
• Ahn CS
• Moon DB
• Ha TY
• Jung DH
• Park GC
• Kim KH
• Kim DY
• Namgung J
• Kang WH
• Kim SH
• Jwa E
• Kwon JH
• Cho HD
• Jung YK
• Kang SH
• Lee SG

• KMID: 2397799
• DOI: http://doi.org/10.14701/ahbps.2017.21.4.199

Abstract

BACKGROUNDS/AIMS
Model for End-stage Liver Disease (MELD) score was adopted in June 2016 in Korea.
METHODS
We analyzed changes in volumes and outcomes of deceased donor liver transplantation (DDLT) for 1 year before and after introduction of MELD scoring at Asan Medical Center.
RESULTS
There were 64 cases of DDLT in 1 year before MELD introduction and 106 in 1 year after MELD introduction, an increase of 65%. The volume of DDLTs abruptly increased during first 3 months, but then returned to its usual level before MELD introduction, which indicated 3-month depletion of accumulated recipient pool with high MELD scores. The number of pediatric DDLT cases increased from 3 before MELD introduction to 11 after it, making up 21.4% and 47.8% of all cases of pediatric liver transplantation, respectively. The number of cases of retransplanted DDLTs increased from 4 to 27, representing 6.3% and 25.5% of all DDLT cases, respectively. The number of status 1 DDLT cases increased from 5 to 12, being 7.8% and 11.3% of all cases. Patient survival outcomes were similar before and after MELD introduction.
CONCLUSIONS
The number of DDLTs temporarily increased after adoption of MELD scoring due to accumulated recipient pool with high MELD scores. The numbers of retransplanted and pediatric DDLT cases significantly increased. Patient survival in adult and pediatric DDLT was comparable before and after adoption of MELD scoring. These results imply that Korean MELD score-based allocation system was successfully established within its first year.

Keyword

Liver transplantation; MELD score; Survival

MeSH Terms

Adult
Chungcheongnam-do
Humans
Korea*
Liver Diseases*
Liver Transplantation*
Liver*
Tissue Donors*

Figure

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  Fig. 1 The monthly incidences of deceased donor liver transplantation (DDLT) volumes during 1 year before (A) and after (B) MELD score application.

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  Fig. 2 Comparison of the annual liver transplantation (LT) volume before and after MELD score application. DD, deceased donor; LD, living donor.

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  Fig. 3 Distribution of patients with MELD scores before and after the introduction of MELD scoring, not including status 1.

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  Fig. 4 Comparison of adult patient survival curves after deceased donor liver transplantation before and after MELD score application.

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