TY  - CHAP
M1  - Book, Section
TI  - Chapter 425. End-Stage Liver Disease
A1  - Ng, Vicky Lee
A2  - Rudolph, Colin D.
A2  - Rudolph, Abraham M.
A2  - Lister, George E.
A2  - First, Lewis R.
A2  - Gershon, Anne A.
PY  - 2011
T2  - Rudolph's Pediatrics, 22e
AB  - End-stage  liver  disease  is  a  term  that  is  applied  to  chronic  liver  disease  that  is  associated  with  minimal  liver  function  or  severe  complications  that  may  lead  to  death.  Cirrhosis  represents  a  final  common  histologic  pathway  for  a  wide  variety  of  liver  diseases,  being  characterized  by  diffuse  fibrosis  and  conversion  of  the  normal  liver  architecture  in  to  structurally  abnormal  nodules  (Fig.  425-1).  Often  there  is  a  poor  correlation  between  histology  and  the  clinical  status  of  the  patient.  Some  patients  with  cirrhosis  are  essentially  asymptomatic  whereas  others  have  all  of  the  sequelae  of  chronic  liver  disease  discussed  below.  In  the  era  of  liver  transplantation  various  attempts  to  measure  the  severity  of  chronic  liver  disease  have  been  applied  in  order  to  determine  to  prioritize  organ  distribution  for  liver  transplantation  such  that  the  sickest  patients  received  organs.  The  measure  now  applied  in  North  America  is  the  Model  of  End-Stage  Liver  Disease,  or  MELD  score.  The  MELD  score  is  calculated  using  laboratory  values  including  the  bilirubin,  INR  and  serum  creatinine.  The  scoring  system  has  been  modified  for  children  less  than  age  12  years  (PELD  score)  such  that  it  uses  other  measures  of  chronic  disease  relevant  in  children  including  serum  albumin,  bilirubin,  INR,  growth  failure  (based  on  gender,  height  and  weight)  and  age  at  listing.  Calculators  to  determine  the  MELD  and  PELD  scores  are  available  at:  http://www.unos.org/resources/meldpeldcalculator.asp  (accessed  March  2,  2010).  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=7039027
ER  -