Accuracy of the Pediatric End-stage Liver Disease Score in Estimating Pretransplant Mortality Among Pediatric Liver Transplant Candidates

JAMA Pediatrics
Chung-Chou H ChangMark S Roberts

Abstract

Fair allocation of livers between pediatric and adult recipients is critically dependent on the accuracy of mortality estimates afforded by the Pediatric End-stage Liver Disease (PELD) and Model for End-stage Liver Disease, respectively. Widespread reliance on exceptions for pediatric recipients suggests that the 2 systems may not be comparable. To evaluate the accuracy of the PELD score in estimating 90-day pretransplant mortality among pediatric patients on the United Network for Organ Sharing (UNOS) waiting list. Patients who were listed from February 27, 2002, to March 31, 2014, for primary liver transplant were included in this retrospective analysis and were followed up for at least 2 years through June 17, 2016. The study analyzed 2 cohorts using the UNOS Standard Transplant Analysis and Research data files. The full cohort comprised 4298 patients (<18 years of age) who had chronic liver disease (excluding cancer). The reduced cohort (n = 2421) excluded patients receiving living donor transplantation or PELD exception points. Observed and expected 90-day pretransplant mortality rates evaluated at 10-point interval PELD levels. Among the 4298 patients in the full cohort (mean [SD] age, 2.5 [4.2] years; 2251 [52.4%] female...Continue Reading

References

May 18, 2000·International Journal of Technology Assessment in Health Care·O P RyynänenJ Takala
Aug 2, 2002·Transplantation·Sue V McDiarmidUNKNOWN Principal Investigators and Institutions of the Studies of Pediatric Liver Transplantation (SPLIT) Research Group
Jan 4, 2003·Gastroenterology·Russell WiesnerUNKNOWN United Network for Organ Sharing Liver Disease Severity Score Committee
Mar 22, 2014·Liver International : Official Journal of the International Association for the Study of the Liver·Maurizio BiselliMauro Bernardi
Oct 28, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H J BraunJ P Roberts

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Citations

Dec 7, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Emily R PeritoJennifer C Lai
Jul 26, 2019·Pediatric Transplantation·Vicky Lee NgJohn C Bucuvalas
Aug 2, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Sonja M SwensonEmily R Perito
Mar 7, 2020·Pediatric Transplantation·Renata Silva Duarte Dos SantosSandra Maria Gonçalves Vieira
Apr 20, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Evelyn HsuAjay K Israni
Jan 3, 2020·Transplantation·Douglas MogulEvelyn Hsu
Jul 29, 2020·Pediatric Transplantation·Theodore ZhangAbbas Rana
Aug 3, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Muhammad H RazaJuliet Emamaullee
Aug 9, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Ajay K JainSimon Horslen
Aug 1, 2020·Transplantation·Douglas B MogulEvelyn Hsu
Sep 21, 2020·The Journal of Pediatrics·Ioannis A ZiogasSophoclis P Alexopoulos
Feb 23, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nabeel A WahidRobert S Brown
Jun 3, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Leanne ThaljiDaryl J Kor
Apr 20, 2021·Medical Journal, Armed Forces India·Aradhana AnejaRohit Kohli
Mar 16, 2021·Journal of Pediatric Gastroenterology and Nutrition·Vandana JainMarianne Samyn
Aug 11, 2021·Current Opinion in Organ Transplantation·Fabio MelandroDavide Ghinolfi
Nov 26, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sarah A TaylorUNKNOWN Society of Pediatric Liver Transplantation

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