Anesth Pain Med.  2021 Jan;16(1):68-74. 10.17085/apm.20035.

Changes in the allocation policy for deceased donor livers in Korea: perspectives from anesthesiologists

• Yoo SY
• Kim GS

• KMID: 2512284
• DOI: http://doi.org/10.17085/apm.20035

Abstract

Background
The allocation policy for deceased donor livers in Korea was changed in June 2016 from Child-Turcotte-Pugh (CTP) scoring system-based to Model for End-stage Liver Disease (MELD) scoring system-based. Thus, it is necessary to review the effect of allocation policy changes on anesthetic management.
Methods
Medical records of deceased donor liver transplantation (DDLT) from December 2014 to May 2017 were reviewed. We compared the perioperative parameters before and after the change in allocation policy.
Results
Thirty-seven patients underwent DDLT from December 2014 to May 2016 (CTP group), and 42 patients underwent DDLT from June 2016 to May 2017 (MELD group). The MELD score was significantly higher in the MELD group than in the CTP group (36.5 ± 4.6 vs. 26.5 ± 9.4, P < 0.001). The incidence of hepatorenal syndrome (HRS) was higher in the MELD group than in the CTP group (26 vs. 7, P < 0.001). Packed red blood cell transfusion occurred more frequently in the MELD group than in the CTP group (5.0 ± 3.6 units vs. 3.4 ± 2.2 units, P = 0.025). However, intraoperative bleeding, vasopressor support, and postoperative outcomes were not different between the two groups.
Conclusions
Even though the patient’s objective condition deteriorated, perioperative parameters did not change significantly.

Keyword

Allocation; Liver transplant; Perioperative care; Unrelated donors

Figure

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  Fig. 1. Numbers of patients in the MELD group and the CTP group based on MELD score. MELD: Model for End-stage Liver Disease, CTP: Child-Turcotte-Pugh.

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