Examination of Usefulness of PELD Score for Pediatric Living Donor Liver Transplantation

Abstract

Introduction: The PELD score is used for children younger than 12 years, but its usefulness has not been well reported. Thus, we examined whether the PELD score affects short-term and long-term outcome. Methods: Of the 85 cases of pediatric living donor liver transplantation (PLDLT) performed from July 1991 to August 2020, 58 cases in which PELD scores could be calculated retrospectively using medical records. Of these, group A with a PELD score of less than 10 (n=34) and group B (n=24) with a score of 10 or more were compared. Results: In 80% of all cases, the primary disease was biliary atresia. At the age PLDLT, group B was significantly younger than group A. Group B had significantly higher bleeding volume per body weight and intraoperative transfusion volume. Group B had a longer postoperative hospital stay and a lower overall survival rate than Group A, although this difference was not statistically significant. Postoperative rejection was common in group B. Five patients died postoperatively during the observation period., but there was no clear association with PELD score. Conclusion: In PLDLT, surgery tends to be performed before progression to end-stage liver failure. Especially for patients under one year old, jaundice after Kasai surgery often prolonged, and the PELD score tended to be relatively low. The PELD score seemed to have some usefulness in short-term outcomes. Although, there was no significantly difference in long-term outcome.