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| {{EH}}
| | #redirect[[MELD Score]] |
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| ==Overview==
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| {{SI}}
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| The '''Model for End-Stage Liver Disease''', or '''MELD''', is a scoring system for assessing the severity of [[chronic liver disease]]. It was initially described by Kamath ''et al'' in 2001 and modified by Wiesner ''et al'', also in 2001.
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| It uses the patient's values for serum [[bilirubin]], serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. This score is also used by the [[United Network for Organ Sharing]] (UNOS) and [[Eurotransplant]] for prioritizing allocation of [[Liver transplantation|liver transplants]].
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| It is calculated according to the following formula:
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| :MELD = 3.78[Ln serum bilirubin (mg/dL)] + 11.2[Ln INR] + 9.57[Ln serum creatinine (mg/dL)] + 6.43
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| Caveats with the score include:
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| * The maximum score given for MELD is 40. All values higher than 40 are given a score of 40
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| * If the patient has been dialyzed twice within the last 7 days, then the value for serum creatinine used should be 4.0
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| * Any value less than one is given a value of 1 (i.e. if bilirubin is 0.8, a value of 1.0 is used).
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| '''PATIENTS WITH LIVER CANCER'''
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| Patients with a diagnosis of liver cancer will be assigned a MELD score based on how advanced the cancer is. This staging system is known as the TNM. T stands for the extent of the tumor, N stands for the presence or absence of lymph nodes, and M stands for the presence or absence of metastasis (tumor spread to another organ such as the lung in the case of liver cancer).
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| ==References==
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| * {{cite journal | author=Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D'Amico G, Dickson ER, Kim WR | title=A model to predict survival in patients with end-stage liver disease | journal=Hepatology | year=2001 | pages=464-70 | volume=33 | issue=2 | id=PMID 11172350}}
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| * {{cite journal | author=Wiesner RH, McDiarmid SV, Kamath PS, Edwards EB, Malinchoc M, Kremers WK, Krom RA, Kim WR | title=MELD and PELD: application of survival models to liver allocation | journal=Liver Transpl | year=2001 | pages=567-80 | volume=7 | issue=7 | id=PMID 11460223}}
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| *Melissa Palmer, MD ," Dr. Melissa Palmer's Guide of Hepatitis and Liver Disease". (Published 2004. Penguin Putnam).
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| *More information about the MELD/PELD calculation, UNOS [http://www.unos.org/waitlist/includes_local/pdfs/meld_peld_calculator.pdf]
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| ==See also==
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| * [[Pediatric End-Stage Liver Disease]]
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| ==External links==
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| Online calculator for MELD score/UNOS modification: [http://www.unos.org/resources/MeldPeldCalculator.asp?index=98]
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| {{SIB}}
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| [[Category:Gastroenterology]]
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| [[Category:Hepatology]]
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| [[Category:Medicine stubs]]
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| [[Category:Medical scoring system]]
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| [[Category:Risk calculator]]
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| [[de:MELD-Score]]
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| [[pl:Skala MELD]]
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| {{WH}}
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| {{WikiDoc Sources}}
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