Model for end-stage liver disease score and MELD exceptions: 15 years later

Sumeet K. Asrani, Patrick Sequeira Kamath

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

The model for end-stage liver disease (MELD) score has been used as an objective scale of disease severity for management of patients with end-stage liver disease; it currently serves as the basis of an urgency-based organ-allocation policy in several countries. Implementation of the MELD score led to a reduction in waiting-list registration and waiting-list mortality and an increase in the number of deceased-donor transplants without adversely affecting long-term outcomes after liver transplantation (LT). The MELD score has been used for management of non-transplant patients with chronic liver disease. MELD exceptions serve as a mechanism to advance the needs of subsets of patients with liver disease not adequately addressed by MELD-based organ allocation. Several models have been proposed to refine and improve the MELD score as the environment within which it operates continues to evolve toward transplantation for sicker patients. The MELD score continues to serve and be used as a template to improve upon as an objective gauge of disease severity and as a metric enabling optimization of allocation of scarce donor organs for LT.

Original languageEnglish (US)
Pages (from-to)346-354
Number of pages9
JournalHepatology International
Volume9
Issue number3
DOIs
StatePublished - May 28 2015

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Keywords

  • Asia
  • Hepatopulmonary syndrome
  • Organ allocation
  • Portopulmonary hypertension
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Hepatology

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