Absence of influence of the Korean MELD score-based liver allocation system on pretransplant MELD score in patients undergoing living donor liver transplantation

Background: Model for end-stage liver disease (MELD) score-based allocation system was started in 2016 in Korea. This study aimed to analyze the profiles of adult patients who underwent living donor liver transplantation (LDLT) in the pre- and post-MELD eras. Methods: This study was a retrospective double-arm analysis using a single-institution LDLT cohort. We compared the LDLT re-cipient profiles by focusing on pretransplant MELD score for 4 years before and after the introduction of the MELD score-based allocation system. Patients without and with hepatocellular carcinoma (HCC) were categorized as groups A and B in the pre-MELD era and groups C and D in the post-MELD era, respectively. Results: The number of patients in groups A, B, C and D was 615, 599, 704, and 713, respectively; and their MELD scores were 19.0±9.4, 11.2±5.6, 17.9±8.5, and 11.6±5.7, respectively. Clinical parameters of liver cirrhosis indicate that group A had worse general conditions than group C; and groups B and D had similar general conditions. The comparative analysis between groups A and C revealed the mean and median MELD scores as 19.0±9.4 and 17.9±8.5 (P=0.009), and 16 and 15 (P=0.077), respectively. The comparative analysis