Modified pediatric end‐stage liver disease scoring system and pediatric liver transplantation in Brazil

The Pediatric End‐Stage Liver Disease (PELD) scoring system is a formula developed to provide a continuous numerical assessment of the risk of death in order to allocate livers to children in need of transplantation. The PELD scoring system was introduced in Brazil in July 2006. An important change...

Full description

Saved in:
Bibliographic Details
Published in:Liver transplantation 2010-04, Vol.16 (4), p.426-430
Main Authors: Neto, Joao Seda, Carone, Eduardo, Pugliese, Renata P. S., Fonseca, Eduardo A., Porta, Gilda, Miura, Irene, Danesi, Vera B., Guimaraes, Teresa C., Godoy, Andre L., Porta, Adriana, Vincenzi, Rodrigo, Filho, Francisco Carnevale, Kondo, Mario, Chapchap, Paulo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brazil
Child
Geography
Humans
Liver Diseases - diagnosis
Liver Diseases - therapy
Liver Transplantation - methods
Pediatrics - methods
Severity of Illness Index
Time Factors
Transplantation, Homologous - methods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The Pediatric End‐Stage Liver Disease (PELD) scoring system is a formula developed to provide a continuous numerical assessment of the risk of death in order to allocate livers to children in need of transplantation. The PELD scoring system was introduced in Brazil in July 2006. An important change was made in the system: the final number for listing patients less than 12 years old for transplantation was the calculated PELD score multiplied by 3. The consequences of this allocation policy were analyzed in 2 ways in this research: nationally and in the state of São Paulo (SP State). In the analysis of the national data, a comparison of the pre‐PELD era (July 2003 to July 2006) and the post‐PELD era (August 2006 to April 2009) showed that the total number of pediatric transplants for children under 12 years of age decreased 7%. Regionally, in SP State, there was a 62% increase in the number of deceased donor liver transplantation procedures for the pediatric population after the introduction of the modified PELD system. There was also a 6.1‐fold increase in split liver transplantation as well as a statistically significant decrease in the time on the waiting list (P < 0.001). In conclusion, changing the allocation policy in Brazil in order to benefit pediatric patients on the waiting list had different results according to analyses of national and regional data. A significant increase in deceased donor liver transplantation/split liver transplantation and a shorter time on the waiting list were observed in SP State. The modified PELD scoring system is simple and optimizes the utilization of deceased donor liver grafts in centers performing pediatric transplants. Liver Transpl, 2010. © 2010 AASLD.
ISSN:1527-6465
1527-6473
DOI:10.1002/lt.22000