P0097 PP PEDIATRIC END STAGE LIVER DISEASE (PELD) SCORE AND OUTCOME AFTER LIVER TRANSPLANTATION

Abstract

Introduction: Pediatric End-Stage Liver Disease (PELD) score is now the criteria for allocation in liver transplantation for patients with chronic disease. It has recently been suggested that is a better and a more objective predictor of mortality in patients with end-stage liver disease. Although the score has been effective in the prediction of mortality in patients awaiting liver transplantation, its abilities to predict posttransplantation outcome need study. We aimed to evaluate post-transplant survival of 61 pediatric liver transplant recipients relative to pre-transplant PELD scores in our single transplant center experience from Turkey. Methods: We reviewed charts of 61 children( median age 8; range 0.5–18) who underwent 67 OLT at Ege University Organ Transplantation and Research Center between September 1997 and August 2003. We calculated PELD scores at the time of OLT and correlated scores with patients and graft survival. Pretransplantation PELD score was calculated using the United Network for Organ Sharing formula. Patients were stratified according to PELD score less than 15, 15 to 24, and 25 and higher. Results: Mean and median PELD scores were 22.8 and 24, respectively (range, 1 to 54). Indications of LT were metabolic liver disease (n=17), biliary atresia (n=14), viral hepatitis (n=4), autoimmune hepatitis (n=6), cryptogenic cirrhosis (n=11), fulminant liver failure (n=5) and the others (n=5). Overall 3,6,12,24 and 48 months survival was 87.4%, 85.6%, 81.6, 64.3, respectively. There was no significantly difference between cadaveric and living donor OLT recipients respect of survival rates. There was statistically significant difference between median PELD scores of dead versus living children (32 vs 18; P =0.04). Post-transplantation survival at 3 and 6 months significantly lower in the groups of patients with PELD scores greater than 25 but it did not reach statistically significance (p=0.06). Conclusion: Pretransplantation PELD score does not predict long term outcome after pediatric liver transplantation.