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

In cliot: Clinical Indices and Outcomes Tools

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")

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.

Value

A list containing:

PELD_Cr_Score

The calculated PELD score.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.