What is MELD Score ?

The Model for End-Stage Liver Disease (MELD) score is a numerical scale used in medicine to assess the severity and prognosis of liver disease. It is primarily used for prioritizing patients on the waiting list for liver transplantation. The MELD score incorporates three laboratory values—serum bilirubin, serum creatinine, and the international normalized ratio (INR) of prothrombin time—to estimate the risk of mortality within three months. The formula for calculating the MELD score is as follows: MELD = 3.78 × ln(serum bilirubin [mg/dL]) + 11.2 × ln(INR) + 9.57 × ln(serum creatinine [mg/dL]) + 6.43 The resulting score is a continuous scale ranging from 6 to 40, with higher scores indicating a greater risk of mortality. The MELD score takes into account the liver's synthetic function (as reflected by bilirubin and INR) and the kidney's filtration function (as reflected by creatinine). The MELD score is widely used because it provides an objective and standardized method to assess the severity of liver disease and predict short-term survival. It allows healthcare professionals to allocate available liver transplants to patients with the greatest need and highest risk of mortality. How does MELD Score affect my chances of getting liver faster for liver transplant surgery ? The MELD score plays a crucial role in prioritizing patients on the waiting list for liver transplantation. In most countries, including the United States, organs for transplantation are allocated based on the severity of the patient's condition as measured by the MELD score. A higher MELD score indicates a greater urgency for transplantation and a higher risk of mortality without the transplant. When a deceased donor liver becomes available, it is allocated to the patient with the highest MELD score within a certain geographic region or organ allocation system. The idea behind this allocation system is to prioritize patients who are at the highest risk of death from liver disease and who would benefit the most from a liver transplant. In general, patients with a higher MELD score have a better chance of receiving a liver transplant sooner compared to those with a lower score. However, it's important to note that the availability of donor organs, the number of patients on the waiting list, and other factors can also influence the timing of transplantation. It's crucial to work closely with your healthcare team and liver transplant center to understand the specific factors that affect organ allocation in your region or country. They can provide you with the most accurate information regarding your individual situation and help guide you through the transplantation process. What is a Paediatric MELD score ? The Pediatric Model for End-Stage Liver Disease (PELD) score is a modified version of the MELD score specifically developed for assessing the severity and prioritizing pediatric patients (under 12 years of age) for liver transplantation. The PELD score takes into account different laboratory values and growth failure parameters that are relevant to pediatric patients. The PELD score incorporates the following variables to calculate the score: Total serum bilirubin level Serum albumin level International normalized ratio (INR) of prothrombin time Growth failure parameters, such as age and weight percentiles The formula for calculating the PELD score varies slightly depending on the patient's age. For infants less than 1 year old, the PELD score is calculated as follows: PELD = 0.480 × bilirubin + 1.857 × ln(INR) + 0.957 × ln(serum albumin) + 0.667 × (age in months) + 0.934 × (weight percentile) For children aged 1 to 11 years, the PELD score is calculated as follows: PELD = 1.482 × bilirubin + 0.957 × ln(INR) + 0.468 × ln(serum albumin) + 1.80 × (age in years) Similar to the MELD score, the PELD score ranges from 6 to 40, with higher scores indicating a higher urgency for liver transplantation. The PELD score helps in determining the priority of pediatric patients on the liver transplant waiting list. It takes into account the severity of liver dysfunction, as well as the growth failure parameters that reflect the child's overall health status. This scoring system ensures that the most severely ill pediatric patients receive the appropriate prioritization for liver transplantation.