by What is MELD score?
The MELD score (Model for End-Stage Liver Disease) is a prognostic scoring system that is used to predict the 3-month mortality due to liver disease and to prioritize organ allocation for liver transplantation. The score is based on three laboratory parameters: serum creatinine, serum bilirubin, and international normalized ratio (INR). The score also includes serum sodium level since 2016.
The MELD score ranges from 6 to 40, with higher scores indicating higher risk of death or complications related to liver disease. The score can fluctuate over time depending on the current condition of the patient and the changes in the laboratory values. The score is calculated using the following formula:
MELD = 3.78 × ln(bilirubin [mg/dL]) + 11.2 × ln(INR) + 9.57 × ln(creatinine [mg/dL]) + 6.43 + 1.32 × (137 – sodium [mEq/L]) – [0.033 × (137 – sodium [mEq/L])] × MELD
Where ln is the natural logarithm function. If the patient has been on dialysis at least twice in the past week, the creatinine value is set to 4.0 mg/dL1.
How is the MELD score used in liver transplantation?
The MELD score is used in liver transplantation to prioritize organ allocation for patients with end-stage liver disease who are on the national waiting list. The score reflects the severity of liver disease and the risk of mortality in the next three months. Patients with higher MELD scores are given higher priority to receive a liver from a deceased donor when an organ becomes available. The score is also used to determine the eligibility and urgency of
patients for a living donor liver transplant.
