This is a medical information app developed by clinicians to aid understanding of the Transplant Benefit Score.
Example cases are provided.
It is not possible to enter actual liver disease values.
It is not to be used for any diagnostic or treatment purposes
Each patient is assigned one chronic liver disease category.
If liver cancer see `Cancer` tab (NB: cancer overides these disease groups)
Example bilirubin, INR and sodium values have been provided to generate the disease severity classifications below.
These values cannot be entered in this version of the app.
Minimum UK listing criteria for patients with chronic liver disease is a UKELD of 49 or above.
UKELD is a liver disease severity score consisting of serum bilirubin, INR, sodium and creatinine.
Creatinine is also a marker of renal function and can be altered in the `Additional recipient parameters` box.
Patients with cancer can be listed with any UKELD (including UKELD <49)
Patients with hepatocellular carcinoma (HCC), a primary liver cancer, may be eligible for liver transplantation in the UK. The examples below are all eligible for liver transplantation in the UK.
AFP is a marker of liver cancer (HCC) found in the blood. It must be 1000iu/ml or less to be on the transplant waiting list
NB: Patients with other types of liver cancer may be eligible for Liver transplantation in the UK but allocation is not via TBS
UK model for end stage liver disease. Consists of serum bilirubin, sodium, INR and creatinine. Creatinine (renal function)
can be altered in the `Additional recipient parameters` box.
UKELD>=49 is required to get onto the main UK waiting list.
UKELD>60 indicates `high urgent` disease severity
Model for end stage liver disease (including sodium). Used in the US
Model for end stage liver disease (excludes sodium). Used in the EuroTransplant region
2. Other parameters included in TBS
These parameters were included in TBS version 1 but are not included in TBS version 2
UKELD / MELD parameters
The TBS combines donor parameters with recipient parameters to generate a
specific score for each donor-recipient combination
Cancer
3a. Transplant Benefit Score: Version 1 (March 2018 - Oct 2022)
TBS is based on area under predicted survival curves without transplant and after transplant
Predicted survival without transplant (Need)
Predicted survival after transplant (Utility)
3b. Transplant Benefit Score: Version 2 (Oct 2022 - present)
TBS = Survival AFTER transplant (Utility) - Survival WITHOUT transplant (Need)
