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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 PELD score calculated for any given patient is correlated to their prognosis and how likely they are to die within a certain time period. [3] A higher score correlates with a more critical condition. Thus, liver donations are usually allocated by UNOS according to the PELD score to maximize the life-saving capability of each donated liver. [4]
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]
FibroTest, known as FibroSure in the US, is a biomarker test that uses the results of six blood serum tests to generate a score that is correlated with the degree of liver damage in people with a variety of liver diseases. FibroTest has the same prognostic value as a liver biopsy.
[clarification needed] The subject's Maddrey DF score is determined by blood analysis. The modified Maddrey's discriminant function was originally described by Maddrey and Boitnott [1] to predict prognosis in alcoholic hepatitis. It is calculated by a simple formula using prothrombin time and serum bilirubin concentration: [citation needed]
The score employs five clinical measures of liver disease. Each measure is scored 1–3, with 3 indicating most severe derangement. [1] Either the prothrombin time or INR should be used to calculate the Child–Pugh score, not both.
Depending on the treatment algorithm, additional factors such as advanced liver disease (as classified by Child-Pugh score) or evidence of portal hypertension may also affect suitability for transplantation. [citation needed]