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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 ...
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]
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.
Under current OPTN/ONUS guidelines, patients with cirrhosis and HCC who meet these criteria may be considered for transplantation. [2] 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.
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.
The King's College criteria were described in a seminal publication in 1989 by J.G. O'Grady and colleagues from King's College School of Medicine. [2] 588 patients with acute liver failure who presented to King's College Hospital from 1973 to 1985 were assessed retrospectively to determine if there were particular clinical features or tests that correlated poorly with prognosis.
For example, liver allocation is based partially on MELD score (Model of End-Stage Liver Disease), an empirical score based on lab values indicative of the sickness of the person from liver disease. In 1984, the National Organ Transplant Act (NOTA) was passed; it gave way to the Organ Procurement and Transplantation Network, which maintains the ...
The definitive treatment for hepatorenal syndrome is liver transplantation, and all other therapies can best be described as bridges to transplantation. [1] [23] While liver transplantation is by far the best available management option for HRS, the mortality of individuals with HRS has been shown to be as high as 25% within the first month ...