한국형 멜드 시스템 도입 전후의 뇌사자 간이식 성적 비교: 단일기관 연구
= Comparison Study of Outcomes of Deceased Donor Liver Transplantation before and after Korean Model for End-Stage Liver Disease (MELD) System: Single Center Experience
저자[authors] 이지아 ( Ji A Lee ), 최규성 ( Gyu-seong Choi ), 김종만 ( Jong Man Kim ), 권준혁 ( Chun Hyuck David Kwon ), 조재원 ( Jae-won Joh )
학술지명[periodical name] 大韓移植學會誌
권호사항[Volume/Issue] Vol.32No.1[2018]
발행처[publisher] 대한이식학회
자료유형[Document Type] 학술저널
수록면[Pagination] 7-11
언어[language] Korean
발행년[Publication Year] 2018
주제어[descriptor] Liver transplantation, Model for End-Stage Liver Disease, Allocation, 간이식, 멜드 점수, 장기배정
초록[abstracts]
[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.]