Introduction

The Model for End-Stage Liver Disease (MELD) score is a valuable tool used by healthcare professionals to assess the severity of chronic liver disease. It plays a crucial role in determining the priority of patients on the liver transplantation waiting list. In this article, we will discuss the importance of MELD score, its calculation, and how it helps in making critical decisions regarding liver transplantation.

Importance of MELD Score

MELD score is instrumental in predicting three-month mortality risk among patients with end-stage liver disease. It aids medical professionals in allocating livers for transplantation objectively and fairly. The higher the MELD score, the greater the urgency for liver transplantation.

Calculating the MELD Score

The MELD score is calculated using the serum levels of three laboratory parameters: bilirubin, creatinine, and international normalized ratio (INR) for prothrombin time. The original formula is as follows:
MELD Score = 3.8 × log_e(Bilirubin) + 11.2 × log_e(INR) + 9.6 × log_e(Creatinine) + 6.4 × (etiology: 0 if cholestatic or alcoholic, 1 otherwise)

While using this formula, there are certain rules to consider:

1. If any laboratory value is <1, use a value of 1.

2. If a patient is on dialysis twice within a week before testing, assign a creatinine value of 4.

For ease of calculation without having to deal with logarithms manually, there are several online calculators available that can compute the MELD score accurately.

Interpreting the MELD Score

Once you have calculated the MELD score, it’s crucial to understand its implications on an individual’s health. Here’s what the MELD score range signifies:

– MELD Score of 6-9: Low risk of 3-month mortality

– MELD Score of 10-19: Moderate risk of 3-month mortality

– MELD Score of 20-29: High risk of 3-month mortality

– MELD Score of 30-39: Very high risk of 3-month mortality

– MELD Score ≥40: Extremely high risk of 3-month mortality

It is important to note that the MELD score is not a static number. As a patient’s condition improves or worsens, their laboratory values may fluctuate, resulting in changes to their MELD score. As such, regular monitoring and updating the MELD score will help in accurate assessment and prioritization for liver transplantation.

Conclusion

In conclusion, the MELD score plays a critical role in assessing end-stage liver disease severity and helps medical professionals prioritize patients for liver transplantation. By understanding how to calculate and interpret the MELD score, physicians can provide timely and appropriate management to improve patients’ quality of life and survival chances.