Pediatric end-stage liver disease (PELD) is a disease severity scoring system for children under 12 years of age. It is calculated from the patient's
albumin
Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water-soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Albumins ...
,
bilirubin, and
international normalized ratio
The prothrombin time (PT) – along with its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) – is an assay for evaluating the ''extrinsic'' pathway and common pathway of coagulation. This blood test is a ...
(INR) together with the patient's age and degree of
growth failure. This score is also used by the
United Network for Organ Sharing
The United Network for Organ Sharing (UNOS) is a non-profit, scientific and educational organization that administers the only Organ Procurement and Transplantation Network (OPTN) in the United States, established () by the U.S. Congress in 1984 ...
(UNOS) for prioritizing allocation of
liver transplants.
Determination
PELD uses the patient's values for serum
bilirubin, serum
albumin
Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water-soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Albumins ...
, the
international normalized ratio for prothrombin time (INR), whether the patient is less than 1 year old, and whether the patient has growth failure (<-2 standard deviation) to predict survival. It is calculated according to the following formula:
:PELD = 4.80
n serum bilirubin (mg/dL)+ 18.57
n INR- 6.87
n albumin (g/dL)+ 4.36(<1 year old) + 6.67(growth failure)
Usage
The PELD score calculated for any given patient is correlated to their prognosis and how likely they are to die within a certain time period. A higher score correlates with a more critical condition. Thus, liver donations are usually allocated by UNOS according to the PELD score to maximize the life-saving capability of each donated liver.
See also
*
Liver transplantation
*
MELD
*
MELD-Plus
References
External links
PELD CalculatorUnited Network for Organ Sharing
Diseases of liver
Medical scoring system
Digestive system procedures
{{Digestive system procedures