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. 2021 Dec;101(6):360-367.
doi: 10.4174/astr.2021.101.6.360. Epub 2021 Dec 1.

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 single-center study

Doo-Ho Lee  1 , Yeon Ho Park  1 , Seok Won Choi  1 , Kug Hyun Nam  1 , Sang Tae Choi  1 , Doojin Kim  1
Affiliations

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 single-center study

Doo-Ho Lee et al. Ann Surg Treat Res. 2021 Dec.

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.

Keywords: Alcoholic fatty liver; Liver cirrhosis; Liver transplantation; Model for End-Stage Liver Disease; Morbidity.

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Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Kaplan-Meier curve for overall survival between the 2 groups. MELD, Model for End-Stage Liver Disease.
Fig. 2
Fig. 2. Kaplan-Meier curve for 12-month survival between the 2 groups. MELD, Model for End-Stage Liver Disease.
See this image and copyright information in PMC

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