Detailed Abstract
[Poster Presentation 3 - Liver (Transplantation)]
[LV PP 3-S4] Survival Benefits in Living-donor Liver Transplantation: a Nested Case-control Analysis Based on the MELD Score Trajectories from the Waitlist
Seung Hyuk YIM 1, Deok-Gie KIM 1, Minyu KANG 1, Hwa-Hee KOH 1, Mun Chae CHOI 1, Eun-Ki MIN 1, Jae Geun LEE 1, Dong Jin JOO 1, Myoung Soo KIM 1
1 Department of Surgery, Severance Hospital, REPUBLIC OF KOREA
Background : The suitability of LDLT for patients with different MELD scores has been a subject of considerable debate. While earlier studies indicated benefits of LDLT predominantly for patients with MELD scores under 15, recent findings suggest LDLT has survival benefits in MELD-Na scores of 11 or greater. Therefore, we aimed to assess the survival advantage of LDLT over waiting for DDLT in a comprehensive range of MELD scores.
Methods : This study encompassed patients on the LT waitlist at a single center from June 2005 to December 2021. Patients under 18 and those with malignancies, including HCC, were excluded. A nested case-control analysis with a 1:4 match was implemented, comparing LDLT recipients with MELD trajectory controls (n=25,735). Overall survival rates were compared between the LDLT and the Wait-more groups.
Results : From 1954 cases, 344 were in the LDLT and 1610 were in the Wait-more group. Both groups had similar characteristics, except for admission duration within 3 months (6.0 days in LDLT vs. 4.0 in Wait-more, P=0.023). In Kaplan-Meier survival analysis, the LDLT group demonstrated higher survival rates (1-year, 89.3% vs. 65.1%; 5-year, 82.2% vs. 46.7%; p<0.001). Sub-group analysis of MELD score category showed the LDLT group consistently demonstrating improved survival over the Wait-more group, notable even in the MELD 6-10 (1-year, 95.8% vs. 86.8%; 5-year, 87.4% vs. 60.4%, P=0.017) and extending to MELD scores of 36 or higher (1-year, 74.8% vs. 21.9%; 5-year, 65.7% vs. 20.0%; P<0.001).
Conclusions : LDLT offers a survival benefit across a broad spectrum of MELD scores, highlighting its potential wider applicability.
Methods : This study encompassed patients on the LT waitlist at a single center from June 2005 to December 2021. Patients under 18 and those with malignancies, including HCC, were excluded. A nested case-control analysis with a 1:4 match was implemented, comparing LDLT recipients with MELD trajectory controls (n=25,735). Overall survival rates were compared between the LDLT and the Wait-more groups.
Results : From 1954 cases, 344 were in the LDLT and 1610 were in the Wait-more group. Both groups had similar characteristics, except for admission duration within 3 months (6.0 days in LDLT vs. 4.0 in Wait-more, P=0.023). In Kaplan-Meier survival analysis, the LDLT group demonstrated higher survival rates (1-year, 89.3% vs. 65.1%; 5-year, 82.2% vs. 46.7%; p<0.001). Sub-group analysis of MELD score category showed the LDLT group consistently demonstrating improved survival over the Wait-more group, notable even in the MELD 6-10 (1-year, 95.8% vs. 86.8%; 5-year, 87.4% vs. 60.4%, P=0.017) and extending to MELD scores of 36 or higher (1-year, 74.8% vs. 21.9%; 5-year, 65.7% vs. 20.0%; P<0.001).
Conclusions : LDLT offers a survival benefit across a broad spectrum of MELD scores, highlighting its potential wider applicability.
SESSION
Poster Presentation 3
Zone C 3/21/2024 2:50 PM - 3:30 PM