Saturday November 11, 2006
Assessment of cirrhosis !! - Part 2 - MELD score

Editors' note: Yesterday we did The Child-Turcotte-Pugh (CPS) score (click here to see). Today we are doing "model for end stage liver disease" (MELD) score for assessment of cirrhosis.


Evaluating prognosis in Cirrhosis via "model for end stage liver disease" (MELD) score

In february 2002, a new methodology for allocating livers for transplantation has been introduced to avoid any subjective criteria favoritism with 100% based mathematical equation. The equation calculates a patient’s likelihood of dying within three months from their liver disease and so the sickest patient gets the liver transplant.

3.8 x log (e) (bilirubin mg/dL) + 11.2 x log (e) (INR) + 9.6 log (e) (creatinine mg/dL)

Another version is

0.957 loge (creatinine [mg/dl]) +0.378 loge (bilirubin [mg/dl]) + 1.120 loge (INR) +0.643 (cause of cirrhosis).

‘Cause of cirrhosis’ is 0 if alcoholic or cholestatic and 1 for all other causes.

Online quick calculator is

here (www.unos.org)

Interpretation: Scores range from 6-40. A score of 6 means the least ill and a score of 40 means the sickest patient. Patient continue to get re-configured his MELD score periodically while on the transplant waiting list. It may go up or down depending upon the patient’s health.

Addendum: Patients with liver cancer will be assigned a MELD - TNM score together with his cancer stage.