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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
Ann Hepatobiliary Pancreat Surg 2017 Nov;21(4):199-204
Published online November 30, 2017
Copyright © 2017 Ann Hepatobiliary Pancreat Surg.

Soo-Min Ha, Shin Hwang, Gi-Won Song, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Dong-Hwan Jung, Gil-Chun Park, Ki-Hun Kim, Dae-Yeon Kim, Jungman Namgung, Woo-Hyoung Kang, Seok-Hwan Kim, Eunkyoung Jwa, Jae-Hyeon Kwon, Hui-Dong Cho, Yong-Kyu Jung, Sang-Hyeon Kang, and Sung-Gyu Lee

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Received November 1, 2017; Revised November 10, 2017; Accepted November 15, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 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. (Ann Hepatobiliary Pancreat Surg 2017;21:199-204)
Keywords : Liver transplantation; MELD score; Survival