MELD Score

1. Indications
   1. Cirrhosis Prognosis
   2. Liver Transplantation Evaluation
2. Criteria
   1. Serum Bilirubin
   2. INR
   3. Serum Creatinine
   4. Cirrhosis Etiology
      1. Alcohol or Cholestasis: 0
      2. Other etiologies: 1
3. Protocol: Calculation
   1. MELD = 3.8 (Ln Bilirubin) + 11.2 (Ln INR) + 9.6 (Ln Creatinine) + 6.4 (etiology)
      1. Where Ln is logorithm
4. Interpretation: Postoperative Mortality for patients with Cirrhosis
   1. Score 0-5
      1. Mortality at 7 days: 0.6%
      2. Mortality at 30 days: 3.2%
      3. Mortality at 90 days: 7.1%
   2. Score 6-10
      1. Mortality at 7 days: 2.8%
      2. Mortality at 30 days: 8.6%
      3. Mortality at 90 days: 13.9%
   3. Score 11-15
      1. Mortality at 7 days: 7.2%
      2. Mortality at 30 days: 21.9%
      3. Mortality at 90 days: 30.6%
   4. Score 16-20
      1. Mortality at 7 days: 14.6%
      2. Mortality at 30 days: 44.0%
      3. Mortality at 90 days: 55.8%
   5. Score 21-25
      1. Mortality at 7 days: 22.2%
      2. Mortality at 30 days: 55.6%
      3. Mortality at 90 days: 66.7%
   6. Score >26
      1. Mortality at 7 days: 25.0%
      2. Mortality at 30 days: 87.5%
      3. Mortality at 90 days: 87.5%
   7. References
      1. Teh (2007) Gastroenterology
5. Resources
   1. MELD Calculator
      1. http://www.unos.org/resources/MELDcalculator