Severity of End-stage Liver Disease in Liver Transplant Candidate; Comparison of KONOS Status with MELD Score.
10.4285/jkstn.2012.26.2.112
- Author:
Dong Jin JOO
1
;
Myoung Soo KIM
;
Soon Il KIM
;
Kyung Ok JEON
;
Kyu Ha HUH
;
Gi Hong CHOI
;
Jin Sub CHOI
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. ysms91@yuhs.ac
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Tissue and organ procurement;
Resource allocation;
Severity of illness index
- MeSH:
Ascites;
Cytidine Triphosphate;
Hepatic Encephalopathy;
Hepatorenal Syndrome;
Humans;
Liver;
Liver Diseases;
Liver Transplantation;
Medical Records;
Resource Allocation;
Severity of Illness Index;
Tissue and Organ Procurement;
Tissue Donors;
Transplants
- From:The Journal of the Korean Society for Transplantation
2012;26(2):112-119
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We have allocated liver according to the Korean Network Organ Sharing (KONOS) status. However, it was necessary to change the system to a more adequate and objective system. We analyzed the correlation between KONOS status and MELD score under the current status of organ allocation. METHODS: We reviewed medical records of 70 liver recipients as KONOS status 2A and 2B between September 2005 and December 2010. We analyzed their KONOS status, MELD score, clinical characteristics, waiting time, Child-Turcotte-Pugh (CTP) score and clinical symptoms accorded to KONOS status 2A. RESULTS: Mean MELD and CTP score of the 2A group was significantly higher than the 2B group (P<0.001). In the 2B group, the blood types of all recipients were identical to those of the donors. However, 2A group included 7 cases (23.3%) of non-identical blood types. The MELD score of all recipients were correlated with CTP score (R=0.798, P<0.001). However, there was an overlapping area between the 2B group and the 2A group that was registered by the condition of intractable ascites. Those who had hepatorenal syndrome and hepatic encephalopathy showed high MELD score over 20. However, 36.4% of the patients who had only intractable ascites showed a MELD score of less than 20. CONCLUSIONS: CTP score was highly correlated with MELD score. However, KONOS status showed some overlapping area of the MELD score between 2A and 2B groups. We should make an effort to improve KONOS allocation system to meet the Korean situation.
