Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine

Tsang Lau, Jawad AhmadDivision of Liver Diseases, Mount Sinai School of Medicine, New York, USAAbstract: The Model for End-Stage Liver Disease (MELD) score incorporates serum bilirubin, creatinine, and the international normalized ratio (INR) into a formula that provides a continuous variable that i...

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Autores principales:	Lau T, Ahmad J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/c415818656d44382b482834626c1adba
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spelling	oai:doaj.org-article:c415818656d44382b482834626c1adba2021-12-02T02:41:55ZClinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine1179-1535https://doaj.org/article/c415818656d44382b482834626c1adba2013-02-01T00:00:00Zhttp://www.dovepress.com/clinical-applications-of-the-model-for-end-stage-liver-disease-meld-in-a12174https://doaj.org/toc/1179-1535Tsang Lau, Jawad AhmadDivision of Liver Diseases, Mount Sinai School of Medicine, New York, USAAbstract: The Model for End-Stage Liver Disease (MELD) score incorporates serum bilirubin, creatinine, and the international normalized ratio (INR) into a formula that provides a continuous variable that is a very accurate predictor of 90-day mortality in patients with cirrhosis. It is currently utilized in the United States to prioritize deceased donor organ allocation for patients listed for liver transplantation. The MELD score is superior to other prognostic models in patients with end-stage liver disease, such as the Child&ndash;Turcotte&ndash;Pugh score, since it uses only objective criteria, and its implementation in 2002 led to a sharp reduction in the number of people waiting for liver transplant and reduced mortality on the waiting list without affecting posttransplant survival. Although mainly adopted for use in patients waiting for liver transplant, the MELD score has also proved to be an effective predictor of outcome in other situations, such as patients with cirrhosis going for surgery and patients with fulminant hepatic failure or alcoholic hepatitis. Several variations of the original MELD score, involving the addition of serum sodium or looking at the change in MELD over time, have been examined, and these may slightly improve its accuracy. The MELD score does have limitations in situations where the INR or creatinine may be elevated due to reasons other than liver disease, and its implementation for organ allocation purposes does not take into consideration several conditions that benefit from liver transplantation. The application of the MELD score in prioritizing patients for liver transplantation has been successful, but further studies and legislation are required to ensure a fair and equitable system.Keywords: MELD score, liver transplantationLau TAhmad JDove Medical PressarticleDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol 2013, Iss default, Pp 1-10 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Lau T Ahmad J Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine
description	Tsang Lau, Jawad AhmadDivision of Liver Diseases, Mount Sinai School of Medicine, New York, USAAbstract: The Model for End-Stage Liver Disease (MELD) score incorporates serum bilirubin, creatinine, and the international normalized ratio (INR) into a formula that provides a continuous variable that is a very accurate predictor of 90-day mortality in patients with cirrhosis. It is currently utilized in the United States to prioritize deceased donor organ allocation for patients listed for liver transplantation. The MELD score is superior to other prognostic models in patients with end-stage liver disease, such as the Child&ndash;Turcotte&ndash;Pugh score, since it uses only objective criteria, and its implementation in 2002 led to a sharp reduction in the number of people waiting for liver transplant and reduced mortality on the waiting list without affecting posttransplant survival. Although mainly adopted for use in patients waiting for liver transplant, the MELD score has also proved to be an effective predictor of outcome in other situations, such as patients with cirrhosis going for surgery and patients with fulminant hepatic failure or alcoholic hepatitis. Several variations of the original MELD score, involving the addition of serum sodium or looking at the change in MELD over time, have been examined, and these may slightly improve its accuracy. The MELD score does have limitations in situations where the INR or creatinine may be elevated due to reasons other than liver disease, and its implementation for organ allocation purposes does not take into consideration several conditions that benefit from liver transplantation. The application of the MELD score in prioritizing patients for liver transplantation has been successful, but further studies and legislation are required to ensure a fair and equitable system.Keywords: MELD score, liver transplantation
format	article
author	Lau T Ahmad J
author_facet	Lau T Ahmad J
author_sort	Lau T
title	Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine
title_short	Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine
title_full	Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine
title_fullStr	Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine
title_full_unstemmed	Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine
title_sort	clinical applications of the model for end-stage liver disease (meld) in hepatic medicine
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/c415818656d44382b482834626c1adba
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Clinical applications of the Model for End-Stage Liver Disease (MELD) in hepatic medicine

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