Symptons linked to bloods that drive the UKELD score

[Robert1981]

Hi,

I often see on here people who either report bad symptons, but are yet to be transplant ready according to bloods, but also vice versa?

Is there a direct link between any of the bloods that drive the UKELD score and Decompensated symptons?

I.E, varicle bleeds are life threatening, but does this contribute or seen in bloods at all?

I suppose I’m trying to understand that if you follow all the rules (low salt, high protein, exercise, abstinence, medication etc) you may potentially have the same, or worse, bloods compared to the next person who hasn’t followed the rules and is showing severe symptons?

Thank you

[AyrshireK]

The blood results used for calculation of UKELD are serum sodium, serum bilirubin, serum creatine and INR (Blood Clotting time). A minimum score of 49 used to be the level at which someone could be listed for transplant (unless it was someone with liver cancer where UKELD wasn't used - the cancer alone elevated their need).

High bilirubin, low albumin are common factors in decompensated symptoms - jaundice, pruritis (itch) and ascites are symptoms associated with these bloods.

When my hubby was first admitted to hospital due to a massive variceal bleed his bloods were described as massively deranged but he was pulled back from the brink and was out of hospital in 3 weeks. It took him till 2024 (12 years after diagnosis) to reach the stage where transplant was absolutely needed and thankfully received (no ascites, not massively jaundiced, no varices but dreadfully ill with Hepatic Encephalopathy).

UKELD is not the sole way they calculate transplant need nor donor organ allocation- this (for DBD organs) is done using the Transplant Benefit Score. People who arn't fully compliant with medical instructions and certainly those with ongoing drug or alcohol use just don't get listed. Witnessed this first hand during hubbies assessment and during his post t/p hospital stay where others were undergoing assessment and didn't get accepted due to various lifestyle related factors.

You can read assessment listing and transplant protocols on sites like the onecfor say the Scottish Liver Transplant Unit services.nhslothian.scot/sc...

The BLT website has details of Transplant Benefit Score and organ allocation at:- britishlivertrust.org.uk/ne...

Katie

[Robert1981 in reply to AyrshireK]

Thank you. Interesting to know why BMI is listed as a donor characteristic but not a recipient characteristic, and why gender is a relevant characteristic for recipient only. From looking at the list it appears varicle bleeds isn’t relevant for the TBS, albeit guessing it is likely relevant for someone to get on the list in the first place

[AyrshireK in reply to Robert1981]

I guess bmi will come into play in organ size and potentially whether organ could be subject to some fatty change.