title: Balanced approach can help initial outcomes: analysis of initial 50 cases of a new liver transplantation program in East Asia.
abstract: OBJECTIVE
  To evaluate patient triage pattern and outcomes according to types of liver transplantation as part of a new liver transplant program developed in an East Asian country with a limited number of deceased donors.
  
  
  METHODS
  Medical records of initial 50 liver transplantations were reviewed retrospectively.
  
  
  RESULTS
  Twenty-nine patients underwent deceased donor liver transplantation (DDLT) and 21 patients underwent living donor liver transplantation (LDLT). Mean model for end-stage liver disease scores of recipients of DDLT and LDLT were 24.9 ± 11.6 and 13.1 ± 5.4, respectively (P < 0.0001). Twenty-eight patients had HCCs and 17 of them (60.7%) underwent LDLT, which was 80.9% of LDLTs. There were 2 cases of perioperative mortality; each was from DDLT and LDLT, respectively. Median follow-up was 18 months. Overall patient and graft survival rates at 6 months, 1 and 2 years were 95.7%, 93.4%, and 89.8%, respectively. There was no significant difference in survival between DDLT and LDLT. Overall recurrence-free survival rates of hepatocellular carcinoma (HCC) patients at 6 month, 1, and 2 years were 96.3%, 96.3%, and 90.3%, respectively. There was no significant difference in recurrence-free survival between DDLT and LDLT.
  
  
  CONCLUSIONS
  As a new liver transplant program with limited resource and waiting list, patients with critical condition could undergo DDLT whereas relatively stable patients with HCCs were mostly directed to LDLT. We recommend a balanced approach between DDLT and LDLT for initiating liver transplant programs.
authors.affiliation: Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Dong-Sik
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Young-Dong
authors.initials: YD
authors.lastname: Yu
authors.affiliation: Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Jung
authors.affiliation: Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Sook
authors.initials: KS
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Yeon-Seok
authors.initials: YS
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Soon-Ho
authors.initials: SH
authors.lastname: Um
authors.affiliation: Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sung-Ock
authors.initials: SO
authors.lastname: Suh
keywords: Donor selection; Liver transplantation; Liver transplantation program; Outcome; Survival