MELD Score

  • – MELD score is an algorithm based on objective measures comprising creatinine, bilirubin and INR. The MELD was developed initially to determine the short term prognosis for patients undergoing TIPS. It was considered to be highly accurate for predicting liver-related death
  • – Patients with MELD ≤ 14, the mortality rate with transplantation was found to be higher than that of patients with the same MELD score who had no undergone transplantation. Consequently a MELD score>15 is now considered a valid indication of liver transplantation in a patient with ESLD
  • MELD Score: 3.8 X [S. bilirubin (mg/dl)] + 9.3 X [S. creatinine (mg/dl)] + 11.2 X [INR] + 6.4

Exception of MELD:

  • – Refractory ascites
  • – Uncontrolled recurrent GI bleeding
  • – Repeated encephalopathy
  • – Portopulmonary HTN
  • – Hepatopulmonary syndrome(HPS)
  • – HCC
  • – Metabolic liver disease
  • Patients with MELD score <15 and child B are listed and followed up until they become child C or develop HCC or any condition as a MRELD exception
  • Patients with high MELD (M>30) score are risky with more postoperative morbidity and mortality

*Patients with child score 9 (Child C) and MELD score above 15 are accepted candidates for liver transplantation


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