cliot (version 1.0.0)

peld_cr_score: Pediatric End-Stage Liver Disease (PELD) Score (2023 Update)

Description

Calculates the updated PELD score (often referred to as PELD-Cr) used by the OPTN for liver transplant prioritization in children under 12 years of age. This version, effective July 2023, incorporates serum creatinine into the calculation to better predict waitlist mortality.

Usage

peld_cr_score(bilirubin, inr, albumin, creatinine, age_years, growth_failure,
              on_dialysis = 0, bilirubin_units = "mg/dL",
              albumin_units = "g/dL", creatinine_units = "mg/dL")

Value

A list containing:

PELD_Cr_Score

The calculated PELD score.

Arguments

bilirubin

Numeric. Total Bilirubin level.

inr

Numeric. International Normalized Ratio.

albumin

Numeric. Serum Albumin level.

creatinine

Numeric. Serum Creatinine level.

age_years

Numeric. Patient age in years. (Points added if Age < 1 year).

growth_failure

Numeric (0 or 1). Presence of growth failure (defined as height or weight < -2 standard deviations below the mean for age and gender). (1 = Yes, + points).

on_dialysis

Numeric (0 or 1). History of dialysis (2 or more times in the last week) or 24 hours of CVVHD. (1 = Yes). If Yes, creatinine is set to 4.0 mg/dL.

bilirubin_units

String. Units for bilirubin. "mg/dL" (default) or "umol/L".

albumin_units

String. Units for albumin. "g/dL" (default) or "g/L".

creatinine_units

String. Units for creatinine. "mg/dL" (default) or "umol/L".

Details

The formula is: $$PELD = 10 \times (0.480 \times \ln(Bilirubin) + 1.857 \times \ln(INR) - 0.687 \times \ln(Albumin) + 0.961 \times \ln(Creatinine) + 0.436 \times (Age<1) + 0.667 \times (GrowthFailure))$$ Adjustments: - Bilirubin < 1 set to 1. - INR < 1 set to 1. - Creatinine < 0.1 set to 0.1. - Creatinine > 4 set to 4.

References

OPTN Policy Notice. Update to PELD Score Calculation. 2023.

Examples

# Example 1: Infant with growth failure and renal impairment
# Age 0.5, Bili 3.0, INR 1.5, Alb 2.5, Cr 0.8, Growth Failure Yes
peld_cr_score(3.0, 1.5, 2.5, 0.8, 0.5, 1)

# Example 2: Child, no growth failure, normal renal
# Age 5, Bili 1.0, INR 1.0, Alb 4.0, Cr 0.3, Growth Failure No
peld_cr_score(1.0, 1.0, 4.0, 0.3, 5, 0)