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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.
The United Kingdom Model for End-Stage Liver Disease or UKELD is a medical scoring system used to predict the prognosis of patients with chronic liver disease. It is used in the United Kingdom to help determine the need for liver transplantation. [1] It was developed from the MELD score, incorporating the serum sodium level. [2]
Survival from liver transplantation has been improving over the 1990s, and the five-year survival rate is now around 80%. The survival rate depends largely on the severity of disease and other medical risk factors in the recipient. [124] In the United States, the MELD score is used to prioritize patients for transplantation. [125]
Liver transplantation is a potential treatment for acute or chronic conditions which cause irreversible and severe ("end-stage") liver dysfunction. [4] Since the procedure carries relatively high risks, is resource-intensive, and requires major life modifications after surgery, it is reserved for dire circumstances.
In recent years the advent of liver transplantation and multidisciplinary intensive care support have improved survival significantly. 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.
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.
Liver transplantation, replacing the diseased liver with a cadaveric or a living donor liver, plays an increasing role in treatment of HCC. Although outcomes following liver transplant were initially poor (20%–36% survival rate), [ 20 ] outcomes have significantly improved with improvement in surgical techniques and adoption of the Milan ...