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Effects of Longitudinal Profiles of Pediatric End-stage Liver Disease (PELD) Scores on Post-transplant Survival

SUN, Zhaowen (2012) Effects of Longitudinal Profiles of Pediatric End-stage Liver Disease (PELD) Scores on Post-transplant Survival. Master's Thesis, University of Pittsburgh.

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    Abstract

    Liver transplant has long been the ultimate treatment for patients with end-stage liver disease. For pediatric patients under 12 years old, the Pediatric End-Stage Liver Disease (PELD) scoring system has been developed and implemented for almost 10 years as an estimation of 90-day mortality pre-transplantation. PELD score has been used as an appropriate tool to discriminate patients when allocating organs, yet as a potential predictor of post-transplant graft failure, its effect has been somewhat inconsistent. In previous studies, researchers tended to use single measured PELD score at the time of listing or at transplant in predicting graft survival, while in clinical practice PELD scores are often calculated multiple times between listing and transplant to monitor patients’ disease status. To make the most use of the information of the repeated PELD measures, we propose to employ latent group-based trajectory models to explore the underlying distinct patterns of the PELD scores and then integrate such longitudinal profiles into survival analysis to examine its effects as a predictor of graft survival. Public health significance: This study will provide both the medical and public health communities with important information that will facilitate their evidence-based practice concerning pediatric patients in need of liver transplant. Researchers will get to see the big picture regarding this health issue since national data have been used to derive the results. They will have a better idea of patients’ disease status and prognosis and will be able to make treatment or intervention decisions with more confidence.


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    Item Type: University of Pittsburgh ETD
    ETD Committee:
    ETD Committee TypeCommittee MemberEmail
    Committee ChairChang, Chung-Chou H.changj@pitt.edu
    Committee MemberPike, Francisfrp3@pitt.edu
    Committee MemberYouk, Adayouk@pitt.edu
    Thesis AdvisorChang, Chung-Chou H.changj@pitt.edu
    Title: Effects of Longitudinal Profiles of Pediatric End-stage Liver Disease (PELD) Scores on Post-transplant Survival
    Status: Published
    Abstract: Liver transplant has long been the ultimate treatment for patients with end-stage liver disease. For pediatric patients under 12 years old, the Pediatric End-Stage Liver Disease (PELD) scoring system has been developed and implemented for almost 10 years as an estimation of 90-day mortality pre-transplantation. PELD score has been used as an appropriate tool to discriminate patients when allocating organs, yet as a potential predictor of post-transplant graft failure, its effect has been somewhat inconsistent. In previous studies, researchers tended to use single measured PELD score at the time of listing or at transplant in predicting graft survival, while in clinical practice PELD scores are often calculated multiple times between listing and transplant to monitor patients’ disease status. To make the most use of the information of the repeated PELD measures, we propose to employ latent group-based trajectory models to explore the underlying distinct patterns of the PELD scores and then integrate such longitudinal profiles into survival analysis to examine its effects as a predictor of graft survival. Public health significance: This study will provide both the medical and public health communities with important information that will facilitate their evidence-based practice concerning pediatric patients in need of liver transplant. Researchers will get to see the big picture regarding this health issue since national data have been used to derive the results. They will have a better idea of patients’ disease status and prognosis and will be able to make treatment or intervention decisions with more confidence.
    Date: 24 September 2012
    Date Type: Completion
    Defense Date: 09 August 2012
    Approval Date: 24 September 2012
    Submission Date: 23 July 2012
    Release Date: 24 September 2012
    Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
    Patent pending: No
    Number of Pages: 45
    Institution: University of Pittsburgh
    Thesis Type: Master's Thesis
    Refereed: Yes
    Degree: MS - Master of Science
    Uncontrolled Keywords: Liver Transplant; Pediatric End-Stage Liver Disease; Latent Group-Based Trajectory Model; Graft Failure Rate
    Schools and Programs: Graduate School of Public Health > Biostatistics
    Date Deposited: 24 Sep 2012 09:59
    Last Modified: 04 Jun 2013 10:55

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