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간장 응급도 기준 개선방안 연구 : 간이식 대기자의 생존분석

Other Titles
 Research for Modification of Emergency Status in Deceased Donor Liver Allocation - Survival Analysis of Waiting Patients for Liver Transplantation 
 김명수  ;  이광웅  ;  황신  ;  권준혁  ;  유영경  ;  나양원  ;  유희철  ;  김동식  ;  왕희정  ;  최동락  ;  최인석  ;  김순일 
 Journal of the Korean Society for Transplantation (대한이식학회지), Vol.28(2) : 59-68, 2014 
Journal Title
 Journal of the Korean Society for Transplantation (대한이식학회지) 
Issue Date
Resource allocation ; Liver transplantation ; End stage liver disease
Despite a remarkable increase of deceased donors, organ shortage is the main hurdle of organ transplantation in Korea. Therefore, liver transplantation priority is a major issue of liver allocation. We confront a situation that needs to change in order to achieve more adequate and objective allocation of the system. We considered the MELD system as an alternative to the CTP score and Status system. For application of the MELD system, comparison between two systems is required; and a national-based retrospective review of liver transplantation candidates (waiting list) was conducted as a multi-center collaborative study. Eleven transplant centers participated in this national study. From 2009 to 2012, 2,702 waiting lists were enrolled. After mean 349±412 days follow-up, 967 patients (35.8%) of liver transplantation, 750 patients (27.8%) of drop-out/mortality, and 719 patients (26.6%) on waiting were identified. In analysis of patient mortality during waiting time, status system showed significant difference of waiting mortality by status at registration. However, differences of waiting mortality by MELD system were more prominent and discriminate. In comparisons by MELD score in exclusive Status 2A waiting patients, there was a significant difference of waiting mortality by MELD score. This means that the MELD system is a good predictor of short-term survival after listing compared with status system with CTP score. Korean national-based retrospective study showed the superiority of the MELD system in prediction of short-term mortality and usefulness as a determinant for allocation priority.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myoung Soo) ORCID logo https://orcid.org/0000-0002-8975-8381
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
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