MELD Score – Importance In Liver Transplantation

A very accurate scoring system has been developed for predicting survival in adult patients with liver disease. This system is termed the Model for End-Stage Liver Disease, or MELD. Earlier, patients on the liver transplant waiting list were prioritized to receive a liver transplant according to their “status.” Status depended upon blood tests, signs of severe liver disease and the amount of time spent on the list.

The MELD score was developed by the United Network for Organ Sharing (UNOS), a non-profit charitable organization, which operates the Organ Procurement and Transplantation Network (OPTN). On an ongoing basis, the OPTN/UNOS evaluates new advances and research and adapts these into new policies to best serve patients waiting for transplants. As part of this process, the OPTN/UNOS developed this system for prioritizing candidates waiting for liver transplants based on statistical formulas that are very accurate for predicting who needs a liver transplant most urgently.

Under the MELD scoring system, each patient is given a MELD score based on three lab tests:

• Bilirubin, which measures how effectively the liver makes bile
• INR prothrombin time, which measures the liver’s ability to make clotting factors
• Creatinine, which measures kidney function, often tied closely to liver function

This system assures that donated livers go to the patients in greatest need at that moment. Depending on how critical the disease is, MELD score may be recalculated as often as once a week.

Typical MELD scores are recalculated, if these are:

• 25 or higher: Every week
• 19-24: Every 30 days
• 11-18: Every three months
• 10 or less: Once a year

However, MELD score isn’t the only factor. Other considerations include:

• blood type
• body size relative to the donor’s
• Geographical considerations (i.e. how close patient is to the donor liver)
• Current supply of, and demand for, deceased donor livers

In case of patients with a MELD score less than 15, they are often not listed for a liver transplant because their chance of receiving a liver through traditional allocation is so low, a living-donor liver transplant offers a life-saving option and the opportunity to receive a transplant sooner. By exploring a living donor transplant, patients with a low MELD score can still be considered for a liver transplant.

 

WHY Rela Hospital?

MELD scores are accurately calculated in Rela Hospital, the best hospital for liver transplantation in India. As we have the best liver transplant specialists in India, you can be assured that if your MELD scores are higher, we will make every effort to ensure that you are our priority. As part of our liver transplant program in India, we ensure that our patients get the priority they deserve depending on the severity of their disease.