The impact of PELD on OPTN liver allocation: preliminary results

On February 27, 2002 the United Network for Organ Sharing OPTN implemented a revised system for the allocation of deceased donor livers. When compared to an earlier era, preliminary results for pediatric patients indicate that transplant rates increased for the sickest patients at listing (Status 1) and that death rates decreased for the sickest patients at listing. The PELD score was initially validated with the same data with which it was created and had an AUC ROC of 0.821. Using the UNOS database, with a similar cohort of patients, concordance with 3-month mortality was 0.78. The PELD allocation system is believed to be better than the previous system where elements of medical severity were more objective than subjective. However as more data is collected, further analyses will need to be performed in order to assess the efficacy of PELD allocation and to assess the impact of PELD on post transplant outcomes.