model for end-stage liver disease score (MELD score)
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Indications
- prognosis for post-TIPS patients
- used to prioritize allocation of deceased donor livers for liver transplantation (UNOS) - MELD-sodium
Methods
MELD =
3.8 x (Ln serum bilirubin in mg/dL) +
9.6 x (Ln serum creatinine in mg/dL) +
11.2 x (Ln INR) +
6.4
where Ln = natural logarithm (log e)
MELD-sodium score adds serum sodium giving score better predictive value[2]
- predicts 3 month mortality
- used for liver transplant allocation[2]
Interpretation
MELD scores > 13 portend poor prognosis
MELD scores 15-23 are candidates for TIPS
MELD scores >= 15 should be referred to a transplantation center
MELD scores > 24 best treated with liver transplantation
MELD scores > 20 consider prednisolone[2]
Notes
- since 2002, MELD has been used as basis for deceased donor liver allocation to determine a recipient's immediate need for liver transplantation.
More general terms
References
- ↑ UpToDate 14.1 http://www.utdol.com
- ↑ 2.0 2.1 2.2 2.3 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19 American College of Physicians, Philadelphia 2015, 2018, 2021.
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ MELD score calculator Mayo Clinic. http://www.mayoclinic.org/meld/
- ↑ UNOS calculator http://www.unos.org/resources/MELDPeldCalculator.asp?index=98
- ↑ MELD Calculator US Dept of Health & Human Services Organ Procurement and Transplantation Network. https://optn.transplant.hrsa.gov/resources/allocation-calculators/meld-calculator
- ↑ Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0: The Model for End-Stage Liver Disease updated for the modern era. Gastroenterology. 2021;161:1887-1895.e4. PMID: https://pubmed.ncbi.nlm.nih.gov/34481845