부산대학교 도서관

Introduction: Aim was to study the early impact of acuity circle‐based allocation implementation system on liver transplantation for hepatocellular carcinoma (HCC) patients. Methods: We assessed characteristics of HCC and non‐HCC deceased donor orthotopic liver transplants (OLT) in the year before (2/2019–2/2020) and after (3/2020–2/2021) introduction of the acuity circle policy using the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) database. Results: Total OLTs reduced from 6699 in the preacuity circle era to 6660 in the postacuity circle era (−.6%); this decrease is mostly driven by a decrease in HCC transplants (1529 to 1351; −11.6%). Six out of 11 regions had a reduction in the absolute number and percentage of HCC transplants with significant reductions in regions 2 (−37.8%, p <.001) and 4 (−28.3%, p =.001). Discussion: The introduction of median model for end‐stage liver disease (MELD) at transplant minus 3 (MMaT‐3) exception points, has created differential opportunities for HCC patients, in low‐MELD as opposed to high‐MELD areas, despite having the same disease. This effect has become more prominent following the implementation of acuity circle‐based allocation system. Ongoing investigation of these trends is needed to ensure that HCC patients are not disparately disadvantaged due to their location. [ABSTRACT FROM AUTHOR]