Healthcare & Clinical
PELD Score Calculator: Pediatric End-Stage Liver Disease Transplant Formula
Calculate the UNOS Pediatric End-Stage Liver Disease (PELD) score for children under 12 from bilirubin, INR, albumin, age < 1 year, and growth failure (< -2 SD) using floor-clamped natural logarithms.
Why pediatric transplant allocation replaces creatinine with albumin, infant age, and growth failure!
Adult MELD relies heavily on serum creatinine, which underestimates mortality in infants and young children with biliary atresia because low muscle mass keeps creatinine deceptively low while malnutrition and synthetic failure drive mortality! McDiarmid et al. (2002) developed the classic UNOS PELD equation for candidates under age 12 (clamping Bilirubin, INR, and Albumin at >= 1.0 to avoid negative log distortions): PELD = 10 * (0.480 * LN(MAX(Bili, 1)) + 1.857 * LN(MAX(INR, 1)) - 0.687 * LN(MAX(Albumin, 1)) + 0.436 * Age_Under_1yr + 0.667 * Growth_Failure)!
Evaluate an 8-month-old biliary-atresia infant (Age_Under_1yr = 1) with Z-score < -2 growth failure (Growth_Failure = 1), Bilirubin = 6.5 mg/dL, INR = 1.80, and Albumin = 2.6 g/dL: PELD = 24.4 (rounded integer allocation score 24), whereas an older 5-year-old child without growth failure and identical labs scores 13.3 (integer 13)—adding +11.0 points for infant vulnerability and nutritional failure!
| Pediatric Liver Candidate (Bili=6.5, INR=1.8, Alb=2.6) | Age < 1 yr & Growth < -2 SD | Continuous PELD | Rounded Allocation Integer |
|---|---|---|---|
| 8-Month Infant with Growth Failure | Age<1 = 1, Growth = 1 | 24.4 | 24 (High Transplant Priority) |
| 5-Year Child Without Growth Failure | Age<1 = 0, Growth = 0 | 13.3 | 13 (Moderate Priority) |
| Compensated Labs (Bili=0.8, INR=1.0, Alb=4.0, 0, 0) | Clamped >= 1.0 | -9.5 | -10 (Low Waitlist Mortality) |
Continuous UNOS PELD Score (1 Decimal)
Applies the standard >= 1.0 lower clamp via MAX(x, 1) on Bilirubin (B2), INR (B3), and Albumin (B4) plus binary flags Age < 1 yr (B5) and Growth Failure < -2 SD (B6).
=IF(OR(B2 <= 0, B3 <= 0, B4 <= 0, B5 < 0, B5 > 1, B6 < 0, B6 > 1), "Invalid PELD Inputs", ROUND(10 * (0.48 * LN(MAX(B2, 1)) + 1.857 * LN(MAX(B3, 1)) - 0.687 * LN(MAX(B4, 1)) + 0.436 * B5 + 0.667 * B6), 1))Whole-Integer PELD Score
Rounds the continuous PELD score to the nearest whole integer.
=IF(OR(B2 <= 0, B3 <= 0, B4 <= 0, B5 < 0, B5 > 1, B6 < 0, B6 > 1), "Invalid PELD Inputs", ROUND(10 * (0.48 * LN(MAX(B2, 1)) + 1.857 * LN(MAX(B3, 1)) - 0.687 * LN(MAX(B4, 1)) + 0.436 * B5 + 0.667 * B6), 0))Try the example
Use the original values or change them to test your understanding.