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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 ...
Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a condition of the liver in which the normal functioning tissue, or parenchyma, is replaced with scar tissue and regenerative nodules as a result of chronic liver disease.
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]
The surgeon and portal hypertension expert Charles Gardner Child (1908–1991) (with Turcotte) of the University of Michigan first proposed the scoring system in 1964 in a textbook on liver disease. [3] It was modified by Pugh et al. in 1972 in a report on surgical treatment of bleeding from esophageal varices. [4]
Cirrhosis is a late stage of serious liver disease marked by inflammation (swelling), fibrosis (cellular hardening) and damaged membranes preventing detoxification of chemicals in the body, ending in scarring and necrosis (cell death). [11] Between 10% and 20% of heavy drinkers will develop cirrhosis of the liver (NIAAA, 1993).
Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology. Two forms are recognised, acute and chronic (cirrhosis). [ 1 ] Recently, a third form of liver failure known as acute-on-chronic liver failure ( ACLF ) is increasingly being recognized.
Chronic liver disease takes several years to develop and the condition may not be recognised unless there is clinical awareness of subtle signs and investigation of abnormal liver function tests. Testing for chronic liver disease involves blood tests, imaging including ultrasound, and a biopsy of the liver. The liver biopsy is a simple ...
It is generally reserved for patients with fulminant liver failure, failure of shunts, or progression of cirrhosis that reduces the life expectancy to one year. [23] Survival rates in Budd–Chiari syndrome after liver transplantation are 76%, 71% and 68% after 1, 5 and 10 years respectively. [2]
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