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The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease.It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, [1] and was subsequently found to be useful in determining prognosis and prioritizing for receipt of ...
A call for an additional validation of MELD-Plus was published in November 2019 in the European Journal of Gastroenterology & Hepatology. [13]A study presented in June 2019 in Semana Digestiva [14] (Vilamoura, Portugal) demonstrated that MELD-Plus was superior to assess mortality at 180 days vs. other liver-related scores in a population admitted due to hepatic encephalopathy.
Ascites that is refractory to medical therapy is considered an indication for liver transplantation. In the United States, the MELD score [ 30 ] is used to prioritize people for transplantation. In a minority of people with advanced cirrhosis that have recurrent ascites, shunts may be used.
Higher UKELD scores equate to higher one-year mortality risk. A UKELD score of 49 indicates a 9% one-year risk of mortality, and is the minimum score required to be added to the liver transplant waiting list in the U.K. [1] A UKELD score of 60 indicates a 50% chance of one-year survival. [2]
In the past, the Child-Pugh classification was used to determine people who were candidates for a liver transplant. [102] Child-Pugh class B is usually an indication for evaluation for transplant. [104] However, there were many issues when applying this score to liver transplant eligibility. [102] Thus, the MELD score was created.
The Model for End Stage Liver Disease for adults and the Pediatric End Stage Liver Disease (PELD score) for children younger than 12 years old are clinical scoring tools that take various clinical criteria into consideration and are used to assess the need for a liver transplant. [5] Higher scores for each clinical scoring tool indicates a ...
The Model for End-Stage Liver Disease (MELD) score has also been found to have similar predictive accuracy in 30-day (MELD > 11) and 90-day (MELD > 21) mortality. Liver cirrhosis develops in 6–14% of those who consume more than 60–80 g of alcohol daily for men and more than 20 g daily for women.
At present overall short-term survival with transplant is more than 65%. [38] Several prognostic scoring systems have been devised to predict mortality and to identify who will require an early liver transplant. These include King's College Hospital criteria, MELD score, and Clichy criteria. [39] [40]
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