Table 5.
Proposed Clinical Severity Score-Paediatric (CSS-P). CSS-P score = MELD/PELD points + cirrhosis complications points + waiting time (maximum score is 40). PELD/MELD points = Aactual PELD∗ or MELD Score∗/2 (rounded off). Points capped at 20 (Use PELD for children <12 years, MELD for children 13–18 years).
| Cirrhosis complications points – Maximum of three complications can be considered | |
|---|---|
| Complications | Points added |
| Variceal bleeding | 5 |
| Moderate HPS (PaO2 <80 mm Hg and >60 mm Hg on room air) | 5 |
| Severe HPS (PaO2 <60 mm Hg on room air) | 10 |
| QOL issues (severe pruritus, frequent hospitalisation, etc) | 5 |
| Exception indications (Automatic allocation of PELD/MELD points) | |
|---|---|
| Indication | Points allocated |
| Hepatoblastoma | 40 |
| Noncirrhotic metabolic liver disease | 20 |
| Non-hepatoblastoma liver tumours | 15 |
| Abernathy syndrome | 15 |
| Multiorgan transplant | 15 |
| Waiting time points | |||||
|---|---|---|---|---|---|
| Waiting time (months) | 0–3 | 3–6 | 6–9 | 9–12 | >12 |
| Points | 0 | 2 | 5 | 7 | 10 |
HPS, hepatopulmonary syndrome; MELD, Model for End-Stage Liver Disease; PELD, Paediatric Model for End-Stage Liver Disease; QOL, Quality of life.
∗All reports used for PELD/MELD score calculation should have been performed within 7 days of updating, performed on the same day (or within 48 h of each other) and must be from a single laboratory, which is either part of a licensed transplant hospital, government institute or is an NABL-accredited laboratory.