Pediatric end-stage liver disease
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shankar Kumar, M.B.B.S. [2]]
Overview
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, bilirubin, and international normalized ratio (INR) together with the patient's age and degree of growth failure. This score is also used by the United Network for Organ Sharing (UNOS) for prioritizing allocation of liver transplants.
PELD Formula
The PELD score is calculated using the following formula: PELD Score = 0.480 x Loge(bilirubin mg/dL) + 1.857 x Loge(INR) - 0.687 x Loge(albumin g/dL) + 0.436 if the patient is less than 1 year old (scores for patients listed for liver transplantation before the patient’s first birthday continue to include the value assigned for age (< 1 Year) until the patient reached the age of 24 months) + 0.667 if the patient has growth failure (<-2 Standard deviation) Multiply the score by 10 and round to the nearest whole number. Laboratory values less than 1.0 are set to 1.0 for the purposes of the PELD score calculation.
The laboratory values needed to calculate the PELD scores may be entered to the hundredths decimal place (two places after the decimal, e.g., 0.01), so that coordinators can enter the value(s) exactly as reported by the laboratory. Waitlist programming will then round values to the tenths decimal place (e.g., 0.1) prior to calculating the PELD score. For example, if a center enters an INR value of 1.82, a value of 1.8 will be used for the calculation of the PELD score.