Annals of Surgical Treatment and Research最新文献

{"title":"Hospital surgical volume, perioperative transfusion, and 30-day mortality after pancreatic surgery: a nationwide population-based retrospective cohort study in South Korea.","authors":"Sunghee Hong, Seyoon Kim, Yun Kyung Jung, Seonju Kim, Junghyun Yoon, Dongho Choi, Boyoung Park","doi":"10.4174/astr.2026.111.3.148","DOIUrl":"10.4174/astr.2026.111.3.148","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated national trends in 30-day mortality following pancreatic surgery and the factors associated with 30-day mortality in South Korea, with special attention to hospital surgical volume and perioperative transfusion as perioperative risk markers.</p><p><strong>Methods: </strong>We performed a retrospective, population-based study using Korean National Health Insurance Service data. Adults who underwent pancreatic surgery during 2012-2020 were included (n = 40,937). The annual 30-day mortality rates were described overall and stratified by year, age, sex, and pancreatic surgical procedure. We analyzed the associations between hospital surgical volume, perioperative transfusion, and 30-day mortality.</p><p><strong>Results: </strong>The annual number of pancreatic surgeries increased from 4,055 in 2012 to 5,278 in 2020, whereas 30-day mortality remained stable (1.2%-1.9%, P-trend = 0.401). Mortality was lowest in high-volume hospitals (1.0%) and highest in the lowest-volume hospitals (5.9%). Perioperative transfusion and greater transfusion volume were strongly associated with increased 30-day mortality; both were more frequent and of greater quantities in lower-volume hospitals. Across the transfusion strata, a higher hospital surgical volume was consistently associated with lower mortality. In multivariable analyses, lower hospital volume and greater transfusion volume were independently associated with increased 30-day mortality, demonstrating a clear volume-outcome gradient and dose-response relationship with the transfusion amount.</p><p><strong>Conclusion: </strong>Despite the increasing surgical volume nationwide, the 30-day mortality after pancreatic surgery in South Korea remained unchanged. Lower hospital volume and perioperative transfusion independently predicted increased 30-day mortality. Given lower transfusion rates in high-volume hospitals, these findings support centralizing pancreatic surgery in specialized centers and highlight the importance of optimized perioperative management.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"148-156"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern and prognosis of perioperative deep vein thrombosis after hip fracture: a single-center retrospective cohort study.","authors":"Jenny Shin, Hyung-Jin Cho, Ji-Sum Moon, Seung-Chan Kim, Kang-Woong Jun, Jeong-Kye Hwang, Mi-Hyeong Kim","doi":"10.4174/astr.2026.111.3.170","DOIUrl":"10.4174/astr.2026.111.3.170","url":null,"abstract":"<p><strong>Purpose: </strong>Patients undergoing hip fracture surgery are at high risk of deep vein thrombosis (DVT) despite standard prophylaxis due to advanced age, surgery or the fracture itself, and immobilization. We investigated the incidence, pattern, and clinical course of DVT in this population.</p><p><strong>Methods: </strong>Consecutive patients who underwent hip fracture surgery at a single institute were included. Lower extremity vein duplex ultrasonography (DUS) was performed preoperatively and again on postoperative day 7. Pharmacologic and mechanical prophylaxis were applied. Treatment-indicated DVT (TI-DVT) was defined as proximal DVT or isolated distal DVT (IDDVT) with a large thrombus burden (TI-IDDVT).</p><p><strong>Results: </strong>Among 154 patients, 34 (22.1%) had preoperative DVT. Twelve patients had TI-DVT (11 TI-IDDVT) and were excluded from further analysis. In the remaining 142 patients, 39 (27.4%) postoperative DVTs were diagnosed, including 19 (13.3%) TI-DVT. Of these, 3 were proximal DVT and 16 were TI-IDDVT. The multivariate analysis identified operation time and the presence of preoperative IDDVT as risk factors for postoperative TI-DVT. The majority of DVT cases were IDDVT, and we further analyzed the prognosis of IDDVT before and after surgery. Twenty-two non-TI-IDDVT cases were identified in preoperative DUS, half of which became TI-DVT after surgery.</p><p><strong>Conclusion: </strong>Most cases of perioperative DVT after hip fracture occurred as IDDVT. Half of these cases progressed to clinically significant DVT. Preoperative IDDVT represents an important predictor of postoperative TI-DVT. Therefore, preoperative DUS needs to be considered in very high-risk patients to allow earlier identification and timely management.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"170-176"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is male sex a barrier to transoral endoscopic thyroidectomy? A comparative study of surgical outcomes.","authors":"Nai-Yu Wang, Yu-Chia Chen, Shiuh-Inn Liu, I-Shu Chen, Tsung-Jung Liang","doi":"10.4174/astr.2026.111.3.133","DOIUrl":"10.4174/astr.2026.111.3.133","url":null,"abstract":"<p><strong>Purpose: </strong>Transoral endoscopic thyroidectomy vestibular approach (TOETVA) presents technical challenges in male patients because of their anatomical characteristics. However, the impact of sex on clinical outcomes following TOETVA remains unclear.</p><p><strong>Methods: </strong>This retrospective study analyzed the baseline characteristics and clinicopathological outcomes of male and female patients who underwent TOETVA between 2019 and 2023. Factors associated with prolonged operative time (above the 75th percentile) were examined using a multivariable logistic regression analysis.</p><p><strong>Results: </strong>Of 131 patients who underwent unilateral lobectomy via the transoral approach, 20 (15.3%) were male. Male patients had significantly higher drainage volumes (75.7 mL <i>vs.</i> 59.3 mL, P = 0.045) and shorter postoperative stays (2.5 days <i>vs.</i> 2.8 days, P = 0.016) compared to females. Ecchymosis lasting >1 week was also more frequent in males (20.0% <i>vs.</i> 5.4%, P = 0.044), and 1 male patient (5.0%, 1/20) experienced chin flap perforation during workspace creation. Other perioperative outcomes, including operative time, blood loss, thyroid gland weight, and pain scores, were comparable between sexes. The rates of vocal cord palsy and incidental parathyroidectomy were also similar. Notably, logistic regression analysis revealed that thyroid gland weight was the sole independent predictor of prolonged operative time (odds ratio, 1.11; 95% confidence interval, 1.03-1.21; P = 0.008), while sex was not associated.</p><p><strong>Conclusion: </strong>TOETVA is feasible in male patients with outcomes generally comparable to females. Surgeons should exercise caution when operating on male patients to minimize soft tissue trauma. Thyroid weight, rather than sex, is the main determinant of operative duration.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"133-138"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of in-hospital delay on clinical and economic outcomes after laparoscopic appendectomy for acute appendicitis: a single-center retrospective cohort study.","authors":"Hanbaro Kim, Jae Woo Shim, Han Zo Choi, Byung Mo Kang","doi":"10.4174/astr.2026.111.3.157","DOIUrl":"10.4174/astr.2026.111.3.157","url":null,"abstract":"<p><strong>Purpose: </strong>Optimal timing of appendectomy after hospital arrival remains controversial. Although early surgery has traditionally been recommended, recent evidence suggests short in-hospital delays may not adversely affect outcomes. This study evaluated the impact of hospital arrival-to-operation time on postoperative outcomes and hospital costs in patients undergoing laparoscopic appendectomy.</p><p><strong>Methods: </strong>We conducted a retrospective study of 661 patients who underwent laparoscopic appendectomy. Patients were categorized into 3 groups according to the interval between hospital arrival and operation start: ≤6 hours (group 1), >6 to ≤12 hours (group 2), and >12 hours (group 3). Baseline characteristics, operative outcomes, postoperative complications, recovery parameters, and hospital costs were compared. Multivariable logistic regression was performed to assess the independent association between in-hospital delay and postoperative complications.</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics were comparable among groups, although American Society of Anesthesiologists classification and serum albumin levels differed slightly. The overall 30-day postoperative complication rates were similar (8.5%, 9.5%, and 10.0% in groups 1, 2, and 3, respectively; P = 0.848). Multivariable analysis showed that in-hospital delay was not independently associated with postoperative complications. No significant differences were observed in severe complications, readmission, mortality, time to oral water intake, soft diet initiation, length of hospital stay, or hospital costs (P = 0.529).</p><p><strong>Conclusion: </strong>An in-hospital delay of >12 hours before appendectomy was not associated with increased postoperative complications, prolonged hospitalization, or higher hospital costs. These findings support flexible scheduling of laparoscopic appendectomy while maintaining safe clinical outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"157-163"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap: overcoming anatomical challenges in kidney transplantation with prosthetic grafts.","authors":"Hyung Sub Park","doi":"10.4174/astr.2026.111.3.131","DOIUrl":"10.4174/astr.2026.111.3.131","url":null,"abstract":"","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"131-132"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical benefit of adjuvant chemotherapy in resected T2N0 distal cholangiocarcinoma: a retrospective cohort study.","authors":"Yoon Soo Chae, Youngmin Han, Seulah Park, Go-Won Choi, Younsoo Seo, Inhyuck Lee, Hye-Sol Jung, Young Jae Cho, Wooil Kwon, Jin-Young Jang, Joon Seong Park","doi":"10.4174/astr.2026.111.3.139","DOIUrl":"10.4174/astr.2026.111.3.139","url":null,"abstract":"<p><strong>Purpose: </strong>Several studies have reported that adjuvant chemotherapy (AC) improves survival outcomes in patients with distal cholangiocarcinoma (dCCA). However, definitive evidence supporting the efficacy of AC in dCCA patients with early T-stage and node-negative disease remains lacking. This study aimed to investigate the clinical benefit of AC and prognostic factors in patients with the early stage of dCCA, with a focus on resected T2N0 dCCA.</p><p><strong>Methods: </strong>A total of 123 patients who underwent curative surgery with pathological confirmation of T2N0 dCCA between 2000 and 2022 were reviewed using prospectively collected clinicopathologic data.</p><p><strong>Results: </strong>No significant between-group differences were observed in 5-year overall survival (OS) (64.8% <i>vs.</i> 68.5%, P = 0.247) and recurrence-free survival (RFS) (54.6% <i>vs.</i> 59.4%, P = 0.317). Furthermore, no significant differences were observed in locoregional RFS (71.7% <i>vs.</i> 75.5%, P = 0.269) and distant metastasis-free survival (71.7% <i>vs.</i> 76.5%, P = 0.414). Multivariate analysis revealed that the effect of AC was not meaningful and only R1 resection was an independent negative prognostic factor for both OS and RFS. In subgroup analysis, neither AC nor adjuvant radiotherapy was associated with survival outcomes in the R1 resection group.</p><p><strong>Conclusion: </strong>Routine use of AC did not significantly improve postoperative survival outcomes in patients with completely resected T2N0 dCCA, nor was its clinical benefit remarkably even in the high-risk group (positive resection margins). Therefore, achieving an R0 resection appears to be more important for improving postoperative survival outcomes in T2N0 dCCA.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"139-147"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve analysis of laparoscopic low anterior resection using the ArtiSential multi-articulating device: a multicenter retrospective cohort study with pooled analysis (STARC trial).","authors":"Seijong Kim, Dae Hee Pyo, Jaeim Lee, Chang Hyun Kim, Heung-Kwon Oh, Yoon Suk Lee, Yong Sik Yoon, Dong Hwan Bae, Byung Soh Min, Jung Wook Huh","doi":"10.4174/astr.2026.111.3.164","DOIUrl":"10.4174/astr.2026.111.3.164","url":null,"abstract":"<p><strong>Purpose: </strong>Robotic surgery has shown promising outcomes in colorectal cancer treatment but is limited by its high cost. In response, the ArtiSential system (LivsMed Inc.), an articulated handheld laparoscopic instrument, has emerged as an alternative. This study aimed to assess the learning curve associated with ArtiSential during low anterior resection (LAR) of colorectal cancer.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study enrolled 208 patients who underwent LAR with ArtiSential between January 2021 and October 2022. A cumulative sum (CUSUM) analysis was conducted for operation time. Three experienced surgeons, each with over 30 completed ArtiSential-assisted LAR procedures, were included in the analysis.</p><p><strong>Results: </strong>The median operation time was 129 minutes; it was accompanied by minimal blood loss and no open conversions. Pathological analysis revealed favorable outcomes with high-quality total mesorectal excision and a circumferential resection margin. Surgeons A and B followed a conventional 4-stage learning curve, achieving mastery after 25 and 24 cases, respectively. In contrast, surgeon C demonstrated a unique 2-stage learning curve, achieving mastery after 19 cases.</p><p><strong>Conclusion: </strong>The CUSUM analysis suggests a relatively manageable learning curve, with the initial phase being completed after approximately 10 cases and proficiency attained after 20-30 cases. In conclusion, ArtiSential appears to be a promising tool for colorectal surgeons, offering a favorable learning curve and encouraging outcomes in LAR for rectal cancer.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"164-169"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dacron vascular grafts: a long-term solution for short renal vein challenges in living donor kidney transplantation in a retrospective case series.","authors":"Ara Cho, Sungsin Cho, Ahram Han, Sangil Min, Jongwon Ha","doi":"10.4174/astr.2026.111.3.177","DOIUrl":"10.4174/astr.2026.111.3.177","url":null,"abstract":"<p><strong>Purpose: </strong>Short renal veins in living donor kidney transplantation present technical challenges during graft placement and vascular anastomosis. Artificial graft use raises concerns about infection and thrombosis. We share our experiences using Dacron vascular grafts (Hemagard, Maquet) for renal vein extension with long-term safety and efficacy.</p><p><strong>Methods: </strong>We retrospectively reviewed 11 cases at Seoul National University Hospital (2016-2024) where Dacron vascular grafts were used for renal vein extension. Patient demographics, comorbidities, graft size, and postoperative antiplatelet therapy were analyzed. Imaging follow-up was performed with sonography before discharge.</p><p><strong>Results: </strong>Patients had a median age of 56 years and a median body mass index of 25.0 kg/m². Eight grafts involved the right kidney and three involved the left kidney. The median graft diameter was 12 mm. At discharge, median serum creatinine was 1.2 mg/dL and median estimated glomerular filtration rate was 63.7 mL/min/1.73 m². Median follow-up was 46 months. One patient required reoperation due to bleeding unrelated to the graft. No thrombosis or stenosis was detected. Vascular patency was excellent in all cases during follow-up, aside from 1 death (pneumonia) and 1 graft failure from immunoglobulin A nephropathy recurrence.</p><p><strong>Conclusion: </strong>Dacron vascular grafts for renal vein extension in living donor kidney transplantation are a reliable and effective surgical option, demonstrating favorable long-term safety and patency without increased thrombotic or infectious complications under antiplatelet management.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 3","pages":"177-182"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative predictors of occult central lymph node metastasis in clinically node-negative papillary thyroid carcinoma: a common data model-based retrospective cohort study.","authors":"Moon Young Oh, Hyejin Hong, Mira Han, Borim Ryu, Young Jun Chai","doi":"10.4174/astr.2026.111.2.69","DOIUrl":"10.4174/astr.2026.111.2.69","url":null,"abstract":"<p><strong>Purpose: </strong>In papillary thyroid carcinoma (PTC), central lymph node metastasis (CLNM) is frequently detected only after surgery, even when preoperative ultrasonography (USG) and CT show no suspicious lymph nodes. Identifying readily available clinical factors associated with occult CLNM may guide the decision for prophylactic central neck dissection in clinically node-negative (cN0) PTC. We investigated factors associated with CLNM using a Common Data Model (CDM)-based cohort.</p><p><strong>Methods: </strong>Patients who underwent thyroid surgery for PTC between 2013 and 2022 and had no suspected nodal metastasis on preoperative USG or CT were included. Demographic and laboratory variables were extracted from the CDM database. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with CLNM.</p><p><strong>Results: </strong>A total of 1,020 patients (246 males, 774 females) were included. The mean age was 50.1 ± 13.2 years. CLNM was identified in 313 patients (30.7%). On multivariable analysis, male sex (adjusted odds ratio [aOR], 1.548; 95% confidence interval [CI], 1.138-2.106; P = 0.005) was independently associated with CLNM, whereas age ≥55 years was inversely associated (aOR, 0.687; 95% CI, 0.515-0.915; P = 0.010). Compared with tumors ≤1 cm, tumor size 1-2 cm (aOR, 2.231; 95% CI, 1.649-3.018; P < 0.001) and >2 cm (aOR, 2.739; 95% CI, 1.711-4.383; P < 0.001) were associated with higher odds of CLNM.</p><p><strong>Conclusion: </strong>In cN0 PTC, male sex, younger age, and larger tumor size were independently associated with occult CLNM. These factors may help identify patients who warrant closer consideration for central neck management despite negative preoperative imaging.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"69-76"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive comparative analysis of eight predictive indices for survival after deceased donor liver transplantation: a retrospective cohort study.","authors":"Jiyoung Baik, Hayeon Do, Suk Min Gwon, Youngju Ryu, Eunjin Lee, Namkee Oh, Jinsoo Rhu, Gyu-Seong Choi, Jongman Kim","doi":"10.4174/astr.2026.111.2.111","DOIUrl":"10.4174/astr.2026.111.2.111","url":null,"abstract":"<p><strong>Purpose: </strong>Deceased donor liver transplantation (DDLT) remains constrained by organ shortages, emphasizing the need for accurate predictive models to optimize allocation and improve outcomes. Although multiple indices, such as Model for End-Stage Liver Disease (MELD), MELD-Na, and donor-specific models, exist to predict recipient and graft survival, their comparative performance remains uncertain.</p><p><strong>Methods: </strong>This study compared 8 predictive models (MELD, MELD-Na, Gender-Equity Model for Liver Allocation [GEMA], GEMA-Na, Donor Rejection Organ Procurement Evaluation, Donor Risk Index, Kidney Donor Profile Index [KDPI], and Korean KDPI) in predicting overall and graft survival after DDLT. Data from 328 donor-recipient pairs at Samsung Medical Center (2000-2020) were retrospectively analyzed. Calibration was assessed using the Hosmer-Lemeshow test and R² values, and discrimination using the Kaplan-Meier curves, concordance statistics (c-index), and receiver operating characteristic curves.</p><p><strong>Results: </strong>MELD-Na demonstrated the highest calibration and discrimination for both overall and graft survival, particularly at short-term follow-up. Recipient-based models (MELD, GEMA) showed satisfactory performance, with MELD closely following MELD-Na in predicting overall survival. In contrast, donor-based indices (KDPI, K-KDPI) exhibited weak predictive power. Integrating recipient and donor parameters improved the overall comprehensiveness of prediction.</p><p><strong>Conclusion: </strong>MELD-Na is the most reliable predictor of short-term survival after DDLT. Donor-specific indices provide valuable insights into organ quality but are limited in survival prediction. Integrating both donor and recipient factors may refine organ allocation and enhance posttransplant outcomes. Further validation across diverse populations and the incorporation of advanced technologies, including machine learning, are warranted to optimize predictive accuracy in liver transplantation.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"111 2","pages":"111-121"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}