Model for End-Stage Liver Disease

The MELD score (Model for End -stage Liver Disease ) indicates the severity of liver disease. It was introduced in 2002 by the United Network for Organ Sharing ( UNOS ), a U.S. organ transplant society, and is used to make with severe hepatic impairment preferred to get a transplant patient.

The MELD score is based on three laboratory parameters as the most reliable predictors of the course of a severe liver disease requiring transplantation (and therefore the relative severity of the disease and the expected remaining lifetime) have been filtered out by scientists at the Mayo Clinic in the United States:

Bilirubin, creatinine, and blood coagulation time, the latter measured by the INR ( international normalized ratio ). The MELD score is calculated from these parameters as follows:

10 x ( 0.957 x ln ( serum creatinine ) 0.378 x ln ( bilirubin tot. ) 1:12 x ln ( INR) 0.643 ).

If dialysis was carried out within the last week, the creatinine level is set equal to 4.0. The score is rounded to integers, it lies between 6 and 40 points, the higher the value, the higher the probability of dying within three months without a transplant. There are adjustments for patients with tumors.

For specific underlying diseases, there is also the so-called Exceptional - MELD, as in certain diseases, the sole calculation of the MELD score is often not the actual need for justice for a donor organ. Thus these individuals are compared with patients with alcohol - or virus- indexed liver cirrhosis at a disadvantage. To compensate for this, there are certain complications " extra points " in the form of Exceptional - MELD. A patient with primary sclerosing cholangitis ( PSC) does this, for example, if two of the following three criteria are met: splenomegaly ( a significantly enlarged spleen ), reduction of BMI by more than 10 % within 12 months and / or two biliary sepsis episodes in 6 months. Further details will be governed by the regularly adjusted guidelines of the German Medical Association for organ allocation for liver transplantation.