MELD Calculator (Model for End-Stage Liver Disease)
For patients with liver disease MELD score determines how quickly he can undergo a liver transplant. The term MELD stands for "model for end-stage liver disease. Typically a MELD calculator provides a score is a number that ranges between 6 and 40, based on lab tests. Degree of liver disorder is identified with the score and higher score indicates severity.
Model for End-Stage Liver Disease or Meld score
Model for End-Stage Liver Disease or Meld score is a score obtained online to know urgency of liver transplant. For patients suffering with liver disease and requiring liver transplantation MELD score calculator is of much use. This online tool helps to know seriousness as well as urgency of liver transplant. There remains a score between 6 and 40 and higher score resembles more serious condition of the patient. In general the online MELD score determining tools are used by the health care providers.
When a Doctor after vivid checkups suggest a liver transplant, it takes time as the patient’s name remains in the waiting list managed by United Network for Organ Sharing, a national organization. Higher the MELD score, higher the need of transplant and while putting a name in this list, this urgency is considered. It is noteworthy MELD score is recalculated from time to time. Medical condition, treatment, and previous MELD score all are factors determining frequency of MELD score recalculation.
Calculation and formula associated to MELD calculation
OnlineMELD score calculator or Model for end-stage liver disease calculator finds the score to prioritize patients with end-stage liver disease as they need transplant planning. The tool for calculating score of Model for End-Stage Liver Disease is a statistical model. Basing upon a cohort of 73 patients and death of 16 patients, a study calibrated the MELD score calculation. It predicts 90 day mortality in case of patients with alcoholic hepatitis.
MELD = 3.78×ln[serum bilirubin (mg/dL)] + 11.2×ln[INR] + 9.57×ln[serum creatinine (mg/dL)] + 6.43
Values of International Normalized Ratio or INR, Creatinine ( in mg/dl) and Bilirubin (in mg/dl) needs to be provided in the online MELD calculator. Then by clicking the “Calculate” button the score can be obtained.
When the MELD score of a patient is:
- Below 10: Yearly calculation necessary
- 11-18: Score is recalculated with a gap of 3 months
- 19-24: Monthly recalculation advisable
- 25 or higher: Weekly recalculation needed
Laboratory tests are essential besides using the MELD calculator
An individual’s MELD score is based on results from several lab tests besides the lab tests as mentioned below:
- Creatinine level: This test provides a report explaining how well the kidneys are functioning
- Bilirubin level: This kind of test determines and finds bille report, bille is a substance cleared by the liver
- International Normalized Ratio or INR: This test is to find how the liver produces factors which controls blood clotting
- Serum sodium level reflects sodium balance in blood
Interpretation of the Model for End-Stage Liver Disease chart
Interpretation chart of the MELD Score in hospitalized patients; the 3 month observed mortality (on the basis of 3437 adult liver transplant patients with chronic liver disease added to the OPTN waiting list at 2A or 2B status between November, 1999, and December, 2001) is as follows:
40 or more — 71.3% observed mortality
30–39 — 52.6% observed mortality
20–29 — 19.6% observed mortality
10–19 — 6.0% observed mortality
<9 — 1.9% observed mortality
Implementation of MELD scores:
The best outcomes with TIPS (transjugular intrahepatic portosystemic shunt) occur among patients with a MELD score less than 14.Patients with MELD scores greater than 24 who are the reasonable liver transplant candidates and they are probably best served by foregoing TIPS or transjugular intrahepatic portosystemic shunt placement.
MELD Score that qualifies for a transplant
MELD is the score used to determine liver transplant for a patient aged more than 12 years. Along with MLED, other health conditions are also determined by medical practitioners before suggesting a transplant. In different State, allocation and availability of liver differs. In general higher score increases probabilities of transplant. Still, it can be inferred that a score higher than 15 may be considered as a mark, basing upon which decision making is initiated by the doctors.
Frequently Asked Questions
Does a MELD score ever go down?
In very rare cases, the MELD score can decrease. However, generally, the MELD score tends to increase over time and does not go down (1).
How long can you live with a MELD score of 19?
A MELD score of 19 indicates a 6% chance of mortality within three months. However, patients with this score may be on the waitlist for as long as a year, and that may deteriorate the condition of the liver and, hence, increase the risk of mortality.
How accurate is the MELD score?
The MELD score is moderately accurate at assessing the severity of liver disease and can be highly useful for deciding potential therapies (2).
Can a MELD score improve?
Yes, the MELD score may improve with treatment (3).
How quickly can a MELD score increase?
The higher the MELD score, the quicker it may fluctuate. That is why those with very high MELD scores are recommended to test once a week.
- 1. Variability of MELD score during the year before liver transplantation
- 2. Accuracy of MELD scores in predicting mortality in decompensated cirrhosis from variceal bleeding, hepatorenal syndrome, alcoholic hepatitis, or acute liver failure as well as mortality after non-transplant surgery or TIPS
- 3. On-Treatment Improvement of MELD Score Reduces Death and Hepatic Events in Patients With Hepatitis B-Related Cirrhosis