MELD (model for end-stage liver disease)

Scale that measures severity of end-stage disease using serum creatinine, bilirubin, albumin and international normalized ratio.

Has value in predicting pre and post liver transplant mortality.

Stratifies patients based on probability of death within 3 months utilizing laboratory data to reflect a patient’s status.

Score used by the United Network for Organ Sharing to allocate organs for donation for liver transplantation.

Score of 15 is the cutoff between risk/benefit ratios for liver transplant.

The patient with the greatest chance of ding without a transplant is allocated the next available organ regardless of the time the patient has spent on a transplant waiting list.

Has reduce the waiting list death rates from 50-125 deaths per 1000 patient years at risk (Freeman).

Has eliminated racial and ethnic differences in time in waiting or waiting list deaths (Moylan).

Because women have less body mass, the inclusion of creatinine rather than weight adjusted glomerular filtration rates is likely to underestimate their renal dysfunction and decreases women’s access to liver allografts.

Using the MELD score and serum sodium concentration predict survival among candidates for liver transplant.

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