Comparison Study of Outcomes of Deceased Donor Liver Transplantation before and after Korean Model for End-Stage Liver Disease (MELD) System: Single Center Experience

Abstract

Background: In June of 2016, the Model for End-Stage Liver Disease (MELD)-based allocation system replaced the Child-Turcotte-Pugh (CTP) score-based system for deceased donor liver transplantation (DDLT) in Korea. This study was conducted to reveal the changes before and after the MELD system. Methods: From January 2015 to March 2017, 71 patient datapoints were collected from recipients who underwent DDLT in a single center. Patients were divided into two groups according to the allocation system (41 in the MELD group, 30 in the CTP group). Results: The MELD score of the two groups differed significantly (36.8±4.5 in the MELD group, 26.0±8.1 in the CTP group, P=0.001). There was no difference in etiology for liver transplantation, 6-month survival rate, or in-hospital stay. However, complication rate and re-admission rate within the first 3 months were higher in the MELD group (78%, 56%). No one received a DDLT because of an incentive system for hepatocellular carcinoma. Conclusions: Despite the short-term follow-up period, the new allocation rule reflects the severity of the patients. Almost all patients who underwent DDLT when they had a high MELD score and then suffered from morbidity; however, this problem was associated with organ shortage, not the allocation system.