Korean J Transplant.  2019 Dec;33(4):112-117. 10.4285/jkstn.2019.33.4.112.

Deceased donor liver transplantation under the Korean model for end-stage liver disease score-based liver allocation system: 2-year allocation results at a high-volume transplantation center

Affiliations
  • 1Organ Transplantation Center, Asan Medical Center, Seoul, Korea. shwang@amc.seoul.kr
  • 2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
The Korean model for end-stage liver disease (MELD) score-based liver allocation system was started in June 2016 in Korea.
METHODS
This study analyzed the detailed allocation results of deceased donor liver transplantation (DDLT) during the first 2 years after the MELD score-based liver allocation system implementation at a high-volume liver transplantation (LT) center in Korea.
RESULTS
This study included 174 patients with age above 12 years. The patient ABO blood groups were A (n=65, 37.4%), B (n=51, 29.3%), O (n=28, 16.1%), and AB (n=30, 17.2%). The LT types were primary LT in 141 patients (81.0%) and retransplantation in 33 (19.0%). The Korean Network for Organ Sharing status categories at LT were as follows: status 1 (n=11, 6.3%), status 2 (n=82, 47.1%), status 3 (n=63, 36.2%), and status 4 (n=18, 10.3%). The mean MELD score at LT and waiting period were 36.6±4.6 and 62.1±98.2 days in blood group A; 37.6±3.6 and 25.7±38.1 days in blood group B; 38.8±2.7 and 26.0±30.5 days in blood group O; and 34.8±5.5 and 68.4±110.5 days in blood group AB (P<0.001 and P=0.012), respectively. Patients with blood group O and AB had the highest and lowest mean MELD scores at LT allocation, respectively.
CONCLUSIONS
Serious deceased organ donor shortage resulted in very high MELD score cutoffs for DDLT allocation. Additionally, a significant inequality was observed in the possibility for DDLT according to blood group compatibility. Nationwide follow-up studies are necessary to precisely determine the allocation status of DDLT.

Keyword

Liver transplantation; Model for end-stage liver disease score; Waiting list; ABO blood group; Deceased donor
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