How is the Model for End-Stage Liver Disease (MELD) scoring system used to determine organ allocation in cirrhosis?

Updated: Jul 30, 2018
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Answer

Answer

In the MELD scoring system for adults, a patient receives a score based on the following formula:

MELD score = 0.957 x Loge (creatinine mg/dL) + 0.378 x Loge (bilirubin mg/dL) + 1.120 x Loge (INR) + 0.643

As an example, a cirrhotic patient with a creatinine level of 1.9 mg/dL, a bilirubin level of 4.2 mg/dL, and an INR of 1.2 would receive the following score:

MELD score = (0.957 x Loge 1.9) + (0.378 x Loge 4.2) + (1.120 x Loge 1.2) + 0.643 = 2.039

That value is then multiplied by 10 to give the patient a risk score of 20. Patients' MELD scores are recalculated every time they undergo laboratory testing. Patients can be assigned a maximum MELD score of 40 points.


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