model for end-stage liver disease score (MELD score)

Indications

• prognosis for post-TIPS patients
• used to prioritize allocation of deceased donor livers for liver transplantation (UNOS) - MELD-sodium

Methods

MELD =

3.8 x (Ln serum bilirubin in mg/dL) +

9.6 x (Ln serum creatinine in mg/dL) +

11.2 x (Ln INR) +

6.4

where Ln = natural logarithm (log e)

MELD-sodium score adds serum sodium giving score better predictive value

• predicts 3 month mortality
• used for liver transplant allocation

Interpretation

MELD scores > 13 portend poor prognosis

MELD scores 15-23 are candidates for TIPS

MELD scores >= 15 should be referred to a transplantation center

MELD scores > 24 best treated with liver transplantation

MELD scores > 20 consider prednisolone

Notes

• since 2002, MELD has been used as basis for deceased donor liver allocation to determine a recipient's immediate need for liver transplantation.

More general terms

• numerical rating scale (NRS)