What Is A MELD Score, And Why Is It Important During Liver Transplantation?

ByDr. Vivek Vij

A MELD score is required for anyone with end-stage liver disease. The score ranges from 6 to 40 and is a measure of the severity of an infection that is damaging the liver. MELD is an acronym for Model for End-stage Liver Diseases and a series of Lab Tests are used to determine the score This lab-based grading system is widely used to measure the severity of illness and determine the liver transplant success rate, if necessary.

Lab Tests For Calculating MELD Score

The MELD score is derived from four normal lab tests.

  • Bilirubin test: This is a test that determines how much bilirubin is present in a patient’s blood.
  • Creatinine Test: This is a test that determines the health and function of the kidneys.
  • Serum Sodium Test: This test determines the amount of sodium in the blood. Abnormal sodium levels might be a sign of a renal disease or another ailment.
  • Prothrombin Time (PT): used to diagnose bleeding or severe clotting disorders.

The MELD Score Range

Given the significance of the MELD score in prioritising liver allocation and predicting listing time, let us examine how patients with end-stage liver disease are classified using the MELD score.

  • (A MELD score of less than 24) or Status 3: Patients with a MELD score of less than 24 are regarded too young for cadaveric transplantation, although live donor transplantation is an option.
  • (Score: 24-29 on the MELD) or Status 2b: Patients with a MELD score of 24-29 do not need to be admitted to the hospital, and the doctor will recommend a transplant date after a thorough examination
  • (MELD Score >29). or Status 2c: Patients with a MELD score of more than 29 must be admitted to the hospital, and a transplant date is set after a thorough examination.

Is A Single MELD Test Enough?

MELD test results fluctuate depending on the health of the liver. It has the ability to both increase and decreases. While patients are on the waiting list, liver surgeons perform numerous MELD tests. This has two advantages:

  • It guarantees that the liver is given to those who need it the most.
  • It dramatically improves the success rate of liver transplants.

All of the categories listed above are for people with end-stage liver disease. The MELD score is not used to assess patients with acute liver failure (ALF). They require liver transplantation as soon as possible. Thanks to technological advancements like laparoscopic liver transplant, wait times have been greatly reduced and recovery has significantly improved. Ideally, the higher the MELD score, the greater the need for an immediate liver transplant.

While the MELD score is a good predictor of the length of time it will take to have a liver transplant, it is not a predictor of transplant success. The success rate of a liver transplant is determined by a number of factors, including the patient’s overall health, the surgeon’s and centre’s experience, and so on. For example, India’s liver transplant success rate is comparable to that of any other affluent country. The surgical success rate in India is around 86%, with a 70% 5-year survival rate.