Advances in liver transplantation allocation systems

Table 1 Child-Turcotte-Pugh scoring system used as prognostic tool in cirrhosis

Parameter	Score
	1	2	3
Encephalopathy	None	Grade I-II	Grade III-IV
Ascites	Absent	Mild	Moderate to Severe
Albumin	> 3.5 g/dL	2.8-3.5 g/dL	< 2.8 g/dL
Prothrombin time prolongation over control (in seconds) or INR	< 4	4-6	> 6
	< 1.7	1.7-2.3	> 2.3
Total Bilirubin	< 2 mg/dL	2-3 mg/dL	> 3 mg/dL

INR: International normalized ratio.

Table 2 Old United Network for Organ Sharing classification for of candidates for liver transplantation

Status	Characteristics
11	Patients with fulminant liver failure or those who their newly transplanted liver does not function
2A	Patients with chronic liver disease, in critical care unit and with life expectancy of < 7 d. They have a CTP score ≥ 10 and meet other medical criteria.
2B	Patients with chronic liver disease becoming more urgently in need of a liver transplantation but do not meet the criteria of status 2A. They have a CTP score ≥ 10, or a CTP score of ≥ 7 and at least one of the other medical criteria.
3	Patients with chronic liver disease under medical care but not admitted in the hospital and do not meet the criteria for status 2B.

¹These most critical patients include patients with fulminant hepatic failure; Primary non-function within 7-d of transplant; hepatic artery thrombosis (HAT) within 7-d of transplant and acute decompensated Wilson’s disease. CTP: Child-Turcotte-Pugh.

Table 3 Current United Network for Organ Sharing status and score assignment for liver transplant candidates

Status 1A: adult or pediatric patient with fulminant hepatic failure

Status 1B: severely ill pediatric patient ( ≤ 18 yr) with MELD or PELD ≥ 25, in ICU

Calculated MELD/PELD score

Exceptional MELD or PELD score

Status 7: inactive status, temporarily unsuitable for transplant

ICU: Intensive care unit; MELD: Model for end-stage liver disease; PELD: Pediatric end-stage liver disease.