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
- Authors
- Doo-Ho Lee; Yeon Ho Park; Seok Won Choi; Kug Hyun Nam; Sang Tae Choi; Doojin Kim
- Issue Date
- Dec-2021
- Publisher
- 대한외과학회
- Keywords
- Alcoholic fatty liver; Liver cirrhosis; Liver transplantation; Model for End-Stage Liver Disease; Morbidity
- Citation
- Annals of Surgical Treatment and Research, v.101, no.6, pp.360 - 367
- Journal Title
- Annals of Surgical Treatment and Research
- Volume
- 101
- Number
- 6
- Start Page
- 360
- End Page
- 367
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/82973
- DOI
- 10.4174/astr.2021.101.6.360
- ISSN
- 2288-6575
- Abstract
- 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.
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