Sept. 17 (UPI) -- The scoring system used to determine who has priority for receiving a liver transplant disadvantages children compared to adults, a study published Monday indicates.
People in need of a liver transplant are put on one of two national wait lists -- one for children 12 and under and one for those older than 12. Each patient is given two scores based on how sick and in need of a new liver they are.
The scoring system is supposed to be an objective way to measure who should be the first to receive a new liver when one becomes available, but researchers at the University of Pittsburgh determined it underestimates the risk of death for children compared to adults. And both children and adults compete for the same livers.
Their findings were published Monday in the medical journal JAMA Pediatrics.
"Anecdotally, pediatric transplant physicians have long recognized the scoring system isn't adequate when comparing children to adults," said senior author Mark S. Roberts, chair and professor of the Department of Health Policy and Management at Pitt Public Health. "Using national, long-term data, our report is the first to demonstrate that the scoring system, on its own, dramatically underestimates the risk of death in the next 90 days and, thereby, disadvantages children."
Researchers made the conclusions after reviewing the records of more than 4,000 patients 17 years old or younger who were on the United Network for Organ Sharing wait list between February 2002 and March 2014.
They found that in the two years after being placed on the list, 62.9 percent of the children received liver transplants, however they were more likely to die than their Pediatric End-stage Liver Disease score predicted.
The adults' score -- the Model for End-stage Liver Disease score -- meanwhile, more accurately predicted death.
"So, you're comparing apples to oranges, and making life and death decisions with that inaccurate and inadequate comparison," said co-author Cindy L. Bryce, associate professor of health policy and management at Pitt Public Health.