Listing for Transplant
The Model for End-Stage Liver Disease (MELD) is a numerical scale, ranging from 6 (less ill) to 40 (gravely ill), that is used for adult liver transplant candidates. It gives each individual a "score" (number) based on how urgently he or she needs a liver transplant within the next three months. The number is calculated by a formula using three routine lab test results:
- bilirubin, which measures how effectively the liver excretes bile;
- INR (prothrombin time), which measures the liver's ability to make blood clotting factors
- creatinine, which measures kidney function. (Impaired kidney function is often associated with severe liver disease.)
The MELD score replaced the previous Status 2A, 2B and 3 categories. The status 1 category (patients who have acute liver failure and a life expectancy of less than 7 days without a transplant) remains in place as the highest priority for receiving an organ and is not affected by the MELD system. A patient's score may go up or down over time depending on the status of his or her liver disease. Many patients will have their MELD score assessed a number of times while they are on the waiting list. This will help ensure that donated livers go to the patients in greatest need at that moment.
How Will Organs Be Allocated Once Available?
(Which patient will get the donor liver?)
Candidates awaiting a liver transplant are assigned a status code derived from a mortality risk score corresponding to the degree of medical urgency, referred to as MELD/PELD scores (The Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease). Donor livers are matched to recipients according to blood type, MELD score and body size.
