RE: Ami - CTP scoring

[Guest guest]

-----Original Message-----On Behalf Of Ami Fox

What is " Child C status " ? Do you know?

It’s the old CTP

(Childs-Turcotte Pugh – doctors who invented it) scoring system. The one UNOS used before switching over

to MELD. Here is the CTP chart: Lowest points – were called a

Childs Class A, higher

points Class B and people with the highest numbers were Childs Class C.

Table 2.

Modified Child-Pued by the United Network for Organ Sharing (

Variable

1

Point

2

Points

3

Points

Encephalopathy

None

Moderate

Severe

Ascites

None

Slight

Moderate

Albumin (mg/dL)

> 3.5

2.8-3.5

< 2.8

PT (INR) prolonged

(sec)

< 4

4-6

> 6

Bilirubin (mg/dL)

PBC

Cirrhosis/primary

PSC

1-4

4-10

> 10

All other diseases

< 2

2-3

> 3

One of the reasons

UNOS stopped using this scoring, was because encephalopathy & ascites were

subjective findings. Who decided

how much ascites someone had or how much HE they suffered from? Some doctors were fudging the numbers to

get patients listed earlier. To be

listed, a patient had to have a score of 7 - *except*

patients with PSC had to have a starting Bilirubin of 4 to get even one point. (The reasoning behind this was –

PSC is a cholestatic disease and we are expected to have high Bilirubin numbers).

Also another problem with this

scoring is that once a patient had reached a score of 3 in each category their

scores could go no higher – which meant there were a lot of really sick people

mixed in with not so sick patients.

Thank goodness they changed systems, as now PSC is classified and judged

the same way as every other liver disease.

HTH Barb in Texas