Upto 1996, allocation of organ for deceased donor liver transplant (DDLT), was based on CTP score, time on the waiting list and whether the patient is at home, in hospital or intensive care unit (ICU). In chronic liver diseases (CLD), accurate prognosis is essential, for prioritization of a patient for organ allocation for liver transplant (LT).1 Prognosis in CLD, is judged by measuring serum bilirubin (mg/dL), serum albumin (g/dL), ascites, encephalopathy, nutritional status (Child-Turcotte : CT 1964).2 Pugh (1973) modified this classification by excluding nutritional status and adding prothrombin time (CTP).3 CTP score is classified as: A (5-6), B (7-9), C (10-15), by allotting 1-3 score for each of the five parameters the higher the score (5-15), the greater the severity of CLD.3ĬTP score has some limitations: (i) assessment of degree of ascites and/or depth of encephalopathy is subjective (ii) measurement of prothrombin time in different laboratories is variable, depending on the sensitivity of the thromboplastin reagent used 4 (iii) serum bilirubin of 3 or 13 mg/dL or prothrombin time increased by 6 or 16 seconds will not alter CTP score 5 (iv) for patients on the waiting list for LT, CTP score is within a narrow range of 7-15 (Child B or C), and some patients may have identical CTP score the time on the waiting list is then taken as a tie-breaker, which is unreliable.6 Downgrading of MELD score for age of recipient and chance of recurrence of the disease is recommended to accurately predict survival after liver transplantation. MELD score is a poor predictor of survival after liver transplantation. In about 15% of patients, it does not accurately predict survival and hence MELD-Na is recommended. MELD score accurately predicts survival in 3 months for cirrhotic patients on the waiting list of liver transplantation. hepatitis.va.gov/cirrhosis/background/cirrhosis-meld-score.Model for End-stage Liver Disease (MELD) measures serum bilirubin (mg/dL), serum albumin (g/dL), International Normalised Ratio (INR) for prothrombin time. What is the MELD score and when do we use it? (n.d.).Use of the Child Pugh score in liver disease. Child–Pugh versus MELD score for the assessment of prognosis in liver cirrhosis: A systematic review and meta-analysis of observational studies. news/improvement/most-active-living-donor-liver-transplant-programs/ The most active living donor liver transplant programs.Child-Turcotte-Pugh score, MELD score, and MELD-Na score as predictors of short-term mortality among patients with end-stage liver disease in northern India. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. If the ascites result is “moderate/diuretic refractory,” that measure would be scored with 3 points.If the ascites result is “mild/diuretic responsive,” that measure would be scored with 2 points.If the ascites result is “none,” that measure would be scored with 1 point.hepatic encephalopathy: brain disorder from liver disease.prothrombin time, prolongation(s) or INR: time for blood to clot.serum albumin: blood protein produced in the liver. ![]() total bilirubin: yellow compound in bile from hemoglobin breakdown.There are five factors that you will select from, and once added up, it’ll determine your score. Child-Pugh score calculatorĭetermining the Child-Pugh score is basically like using a sort of calculator. A score of 1, 2, or 3 is given to each measure, with 3 being the most severe. The Child-Pugh score is determined by scoring five clinical measures of liver disease and the possibility of eventual liver failure.
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