- Model for End-stage Liver Disease
- Statistical model that predicts 3 month mortality in patients with cirrhosis
- Developed to predict who would benefit from TIPS (score < 14) or those who would benefit from direct to transplant (score > 24)
- Now used to prioritise liver transplants
- If a patient has dialysed twice in the last week - the value for the serum creatinine should be 4
- NOT designed for HCC pts
- HCC patients
- The MELD score will not appropriately prioritise HCC patients (will under-predict there mortality)
- Decompensation/derangement may happen late in the cancer disease progression
- Pts may not get prioritised for transplantation early enough
- Priority points now given to HCC patients (Modified MELD)
- In the UK they have modified the MELD to include sodium in the formula - called the MELD-NA
- Is likely more accurate
MELD = 3.8loge(serum bilirubin [mg/dL]) + 11.2loge(INR) + 9.6*loge(serum creatinine [mg/dL]) + 6.4