Changes in the Deceased-Donor Trend in Korea: Establishment of Regional Trauma Centers and KODA

Abstract

South Korea utilizes living-donor liver transplantation to overcome a shortage of deceased donors. After the Korea Organ Donation Agency (KODA) was established, many hospitals were selected to be donor-managing hospital. A nationwide regional trauma center project was carried out separately in 2015. This study aims to analyze how the trend of deceased-donor recruitment and donation has changed based on policy factors such as independent organ-procurement organization (IOPO) activities and establishing regional trauma centers. KONOS data from 2010–2019 were used to analyze the impacts of these policy changes. The results showed that 62 centers had 4395 deceased donors, and 3863 recipients underwent deceased-donor liver transplantation. The two most common causes of donor death are cerebrovascular events and head trauma. When the rate of deceased donors was analyzed by the early period (2010–2014) and the late period (2015–2019), 53 non-trauma centers went from an average of 29.3 cases to 31.0 cases (6.2% increase) annually. Nine regional trauma centers showed a statistically significant increase from an average of 39.8 cases to 70.3 cases (75.9% increase) annually. Based on these policies, he locations where deceased donors are identified are changing. It is necessary to communicate with regional trauma center staff to recruit more deceased donors.

One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea

“…The relatively high short-term mortality rate within 1 year (around 10%) could pose a challenge to performing LDLT in patients with HLA-OWMM. However, the viability of LDLT should be evaluated by comparing the survival rate of patients on the waiting list for DDLT in regions with severe organ shortages, such as South Korea [ 19 , 20 ]. This decision-making process becomes particularly critical when a patient's only available donor is a living one with an HLA-OWMM.…”