Evaluation of the PELD risk score as a severity index of biliary atresia |
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Authors: | Shinkai Masato Ohhama Youkatsu Take Hiroshi Fukuzato Yoshimitsu Fujita Shogo Nishi Toshiji |
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Institution: | a Department of Surgery, Kanagawa Children’s Medical Center, Yokohama, Japan |
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Abstract: | PurposeThe authors evaluated the validity of the Pediatric End-Stage Liver Disease (PELD) Risk Scoring System as a severity index for patients with biliary atresia.MethodsIndividual hospital records of 104 patients with biliary atresia were reviewed at our institution and divided into 3 groups: nontransplant survivors (n = 61), nontransplant deaths (n = 17), and transplant patients (n = 26). PELD risk scores were calculated according to Wiesner et al, multiplied by 10, and rounded to the nearest integer, as is done in determining model of end-stage liver disease (MELD) scores.ResultsThe PELD scores showed a significant difference between nontransplant survivors (range, −21 to 15) and dying nontransplant patients during their last few months of life (range, 2 to 40). No survivors except those below the age of one year recorded scores above 10. Transplant patients had higher scores (range, −5 to 37) before transplantation than nontransplant survivors. However, the scores were not elevated in elderly patients with intractable cholangitis, fulminant variceal rupture, and hepatopulmonary syndrome.ConclusionsPELD profiling is a useful scoring system for selecting patients with the most severe liver dysfunction caused by biliary atresia. However, we advise caution in using this system for patients under the age of 1 year and for older patients with long-term complications. |
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Keywords: | PELD score severity index biliary atresia liver transplantation |
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