The United Network for Organ Sharing (UNOS) has developed a grading scheme based on disease severity for patients awaiting liver transplantation.
Status 1: Fuliminant liver failure, with life expectancy < 7 days
(includes primary graft nonfunction < 7 days after transplantation, hepatic artery thrombosis < 7 days after transplantation, and acute decompensated Wilson's disease)
Status 2A – All of the following:
(2A1) Hospitalized in the intensive care unit (ICU) for chronic liver failure
(2A2) life expectancy < 7 days
(2A3) Child-Pugh score: >= 10
(2A4) one or more of the following:
(2A4a) unresponsive acute variceal hemorrhage
(2A4b) hepatorenal syndrome
(2A4c) refractory ascites
(2A4d) refractory hepatic hydrothorax
(2A4e) stage 3 or 4 hepatic encephalopathy
Status 2B - One or more of the following:
(2B1) Requires continuous medical care AND Child-Pugh score: >= 10
(2B2) Requires continuous medical care AND Child-Pugh score: >= 7 AND one or more of the following:
(2B2a) unresponsive acute variceal hemorrhage
(2B2b) hepatorenal syndrome
(2B2c) refractory ascites
(2B2d) refractory hepatic hydrothorax
(2B2e) spontaneous bacterial peritonitis
(2B3) presence of hepatocellular carcinoma
Status 3 - All of the following:
(3a) requires continuous medical care
(3b) Child-Pugh score: >= 7
(3c) not status 1 or 2
Status 7: Does not require continuous medical care (temporarily inactive)
where:
• The Child-Pugh score ranges from 5 to 15 (see above).
Purpose: To determine the status of a patient awaiting liver transplantation using the United Network for Organ Sharing (UNOS) liver disease severity scale.
Specialty: Gastroenterology
Objective: selection
ICD-10: Z94.4,