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Regional Variation and Use of Exception Letters for Cadaveric Liver Allocation in Children with Chronic Liver Disease
- Source :
- American Journal of Transplantation. 5:1868-1874
- Publication Year :
- 2005
- Publisher :
- Elsevier BV, 2005.
-
Abstract
- The Pediatric End-Stage Liver Disease (PELD) score was designed to reduce subjectivity in liver allocation and to advantage patients with a higher probability of waiting list mortality. The aims of this study were to determine the impact of PELD implementation for children with chronic liver disease and to assess whether PELD met its goal of standardization of liver allocation for children. This study used data reported to the United Network for Organ Sharing (UNOS) registry for children with chronic liver disease receiving primary cadaveric liver transplant between January 2000 and December 2001 (pre-PELD) and March 2002 and July 2003 (PELD). PELD reduced the percentage of children transplanted while in an intensive care unit and as status 1. A calculated PELD score was used for allocation in only 52% of recipients. Thirty percent were status 1 at transplant and PELD scores granted by exception were used for allocation in 18% of patients. There was regional variation in PELD score at allocation and use of exception scores with a significant relationship between PELD score and percentage of exception cases. Regional variation suggests that PELD has not resulted in standardization of listing practices in pediatric liver transplantation.
- Subjects :
- Male
medicine.medical_specialty
Tissue and Organ Procurement
Waiting Lists
medicine.medical_treatment
Liver transplantation
Chronic liver disease
Resource Allocation
law.invention
Liver disease
law
Internal medicine
Cadaver
Humans
Immunology and Allergy
Medicine
Pharmacology (medical)
Organ donation
Child
Retrospective Studies
Transplantation
business.industry
Liver Diseases
Patient Selection
Infant, Newborn
Infant
Retrospective cohort study
medicine.disease
Correspondence as Topic
Intensive care unit
Tissue Donors
Liver Transplantation
Surgery
Treatment Outcome
Liver
El Niño
Child, Preschool
Chronic Disease
Female
business
Subjects
Details
- ISSN :
- 16006135
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- American Journal of Transplantation
- Accession number :
- edsair.doi.dedup.....0b337f466bc44f57ad491a1924a70ed8