Talk:Model for End-Stage Liver Disease

Original source for MELD?

What is the most reliable source (e.g. original paper) for the MELD? JFW | T@lk 09:20, 3 February 2006 (UTC)

This is a good one:

Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D'Amico G, Dickson ER, Kim WR (2001). "A model to predict survival in patients with end-stage liver disease". Hepatology. 33 (2): 464–70. PMID 11172350.{{cite journal}}: CS1 maint: multiple names: authors list (link)

But the calculation of the MELD score has changed over time (e.g. the etiology is no longer included as a factor). UpToDate also has a very comprehensive article on MELD if you have access to that. --WS 11:27, 3 February 2006 (UTC)

This one is also very interesting and also explains the changes to the calculation:

Wiesner RH, McDiarmid SV, Kamath PS, Edwards EB, Malinchoc M, Kremers WK, Krom RA, Kim WR (2001). "MELD and PELD: application of survival models to liver allocation". Liver Transpl. 7 (7): 567–80. PMID 11460223.{{cite journal}}: CS1 maint: multiple names: authors list (link)

--WS 11:32, 3 February 2006 (UTC)

Thanks WS. I wish I had access to Up-To-Date. It would make life much more enjoyable. At least I've got NEJM. JFW | T@lk 04:29, 5 February 2006 (UTC)

TIPS

The MELD is apparently derived from the Mayo TIPS score: PMID 10733541. JFW | T@lk 14:46, 2 March 2007 (UTC)

'Peld' how it's different from meld Ajeeshwikipedia (talk) 07:51, 26 June 2016 (UTC)

References

The following were placed in various spots in the article:

• Wiesner RH, McDiarmid SV, Kamath PS, Edwards EB, Malinchoc M, Kremers WK, Krom RA, Kim WR (2001). "MELD and PELD: application of survival models to liver allocation". Liver Transpl. 7 (7): 567–80. doi:10.1053/jlts.2001.25879. PMID 11460223.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Saab S, Landaverde C, Ibrahim AB; et al. (2006). "The MELD score in advanced liver disease: association with clinical portal hypertension and mortality". Exp Clin Transplant. 4 (1): 395–9. PMID 16827633. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Saab S, Ibrahim AB, Shpaner A; et al. (2005). "MELD fails to measure quality of life in liver transplant candidates". Liver Transpl. 11 (2): 218–23. doi:10.1002/lt.2034510.1002/lt.20345. PMID 15666392. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Saab S, Wang V, Ibrahim AB; et al. (2003). "MELD score predicts 1-year patient survival post-orthotopic liver transplantation". Liver Transpl. 9 (5): 473–6. doi:10.1053/jlts.2003.5009010.1053/jlts.2003.50090. PMID 12740789. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

These can be returned to the article when needed. JFW | T@lk 10:50, 15 February 2010 (UTC)

Controversies

No controversies section? The MELD score is unfair to those suffering from liver disease in which the real sick are passed over for liver transplantation because of sometimes bogus criteria, or the lack or risk some drs are willing to take. —Preceding unsigned comment added by 67.100.21.51 (talk) 05:49, 16 February 2011 (UTC)

That's inherent in anything that relies on information received from the doctor/patient. Not to mention that this criteria isn't bogus, and it is not the only determining factor in who gets the liver (the geographic relationship between the donor and recipient is also taken into account). I feel like the onus is on you to show us why this is bogus or where the controversy is 207.250.239.34 (talk) 15:12, 8 July 2011 (UTC)

Updates

OPTN now uses a recalculated MELD score with blood serum sodium to determine priority on the liver transplant list for those with a score over 11. This inclusion of sodium better reflects mortality rates.

9.1.D MELD Score Candidates who are at least 12 years old receive an initial MELD(i) score equal to: 0.957 x Loge(creatinine mg/dL) + 0. 378 x Loge(bilirubin mg/dL) + 1.120 x Loge (INR) + 0.643 Laboratory values less than 1.0 will be set to 1.0 when calculating a candidate’s MELD score. The following candidates will receive a creatinine value of 4.0 mg/dL:  Candidates with a creatinine value greater than 4.0 mg/dL  Candidates who received two or more dialysis treatments within the prior 7 days  Candidates who received 24 hours of continuous veno-venous hemodialysis (CVVHD) within the prior 7 days The maximum MELD score is 40. The MELD score derived from this calculation will be rounded to the tenth decimal place and then multiplied by 10. <UPDATE HERE> For candidates with an initial MELD score greater than 11, the MELD score is then re-calculated as follows: MELD = MELD(i) + 1.32*(137-Na) – [0.033*MELD(i)*(137-Na)] Sodium values less than 125 mmol/L will be set to 125, and values greater than 137 mmol/L will be set to 137. — Preceding unsigned comment added by 207.118.115.243 (talk) 20:51, 3 March 2020 (UTC)

References