Skip to main content
SpringerLink
Log in

Model for End-Stage Liver Disease (MELD) Score as a Biomarker

  • Reference work entry
  • First Online:
Biomarkers in Liver Disease

  • 1790 Accesses

Abstract

End-stage liver disease (ESLD) due to cirrhosis carries a high mortality. Previous methods to quantify the risk of death in these patients were subjective. The model for end-stage liver disease (MELD) score was developed and is an accurate biomarker of 90-day mortality in patients with ESLD, essentially measuring how sick a patient is. The MELD score incorporates serum bilirubin, creatinine, and INR in a mathematical formula. Since 2002, the MELD score has been used to prioritize deceased donor organ allocation for patients listed for liver transplantation (LT) in the USA. The use of the MELD allocation system has resulted in sicker patients being transplanted with decreased waiting time, thereby decreasing the death rate on the LT waiting list, without an adverse effect on posttransplant outcome. The MELD score has been adopted as a biomarker with good effect in other situations where patients with ESLD have a high risk of dying such as surgery, alcoholic hepatitis, acute liver failure, and variceal bleeding. Since the MELD score was introduced, there have been several modifications that may have increased effectiveness in certain situations. The MELD score is not an accurate biomarker for the risk of death from liver cancer and some other conditions, and hence for the purposes of liver allocation on the transplant list, an exception to the calculated MELD score can be given.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 449.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AH:

Alcoholic hepatitis

CTP:

Child-Turcotte-Pugh

DF:

Discriminant function

ESLD:

End-stage liver disease

FHF:

Fulminant hepatic failure

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C

HRS:

Hepatorenal syndrome

ICU:

Intensive care unit

LT:

Liver transplantation

MELD:

Model for end-stage liver disease

OPO:

Organ procurement organization

OPTN:

Organ procurement and transplantation network

PSE:

Portosystemic encephalopathy

TIPS:

Transjugular intrahepatic portosystemic shunt

UNOS:

United Network for Organ Sharing

References

  • Ahmad J, Downey KK, Akoad M, Cacciarelli TV. Impact of the MELD score on waiting time and disease severity in liver transplantation in United States veterans. Liver Transpl. 2007a;13(11):1564–9.

    Article  PubMed  Google Scholar 

  • Ahmad J, Bryce CL, Cacciarelli T, Roberts MS. Differences in access to liver transplantation: disease severity, waiting time, and transplantation center volume. Ann Intern Med. 2007b;146(10):707–13.

    Article  PubMed  Google Scholar 

  • Ailawadi G, LaPar DJ, Swenson BR, Siefert SA, Lau C, Kern JA, Peeler BB, Littlewood KE, Kron IL. Model for end-stage liver disease predicts mortality for tricuspid valve surgery. Ann Thorac Surg. 2009;87(5):1460–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Alessandria C, Ozdogan O, Guevara M, Restuccia T, Jimenez W, Arroyo V, Rodes J, Gines P. MELD score and clinical type predict prognosis in hepatorenal syndrome: relevance to liver transplantation. Hepatology. 2005;41(6):1282–9.

    Article  PubMed  Google Scholar 

  • Aranha GV, Sontag SJ, Greenlee HB. Cholecystectomy in cirrhotic patients: a formidable operation. Am J Surg. 1982;143(1):55–60.

    Article  CAS  PubMed  Google Scholar 

  • Arroyo V, Gines P, Gerbes AL, Dudley FJ, Gentilini P, Laffi G, Reynolds TB, Ring-Larsen H, Scholmerich J. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996;23(1):164–76.

    Article  CAS  PubMed  Google Scholar 

  • Benckert C, Quante M, Thelen A, Bartels M, Laudi S, Berg T, Kaisers U, Jonas S. Impact of the MELD allocation after its implementation in liver transplantation. Scand J Gastroenterol. 2011;46(7–8):941–8.

    Article  PubMed  Google Scholar 

  • Biggins SW, Rodriguez HJ, Bacchetti P, Bass NM, Roberts JP, Terrault NA. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2005;41(1):32–9.

    Article  CAS  PubMed  Google Scholar 

  • Biggins SW, Kim WR, Terrault NA, Saab S, Balan V, Schiano T, Benson J, Therneau T, Kremers W, Wiesner R, Kamath P, Klintmalm G. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130(6):1652–60.

    Article  PubMed  Google Scholar 

  • Bittermann T, Makar G, Goldberg D. Exception point applications for 15 points: an unintended consequence of the share 15 policy. Liver Transpl. 2012;18(11):1302–9.

    Article  PubMed  Google Scholar 

  • Botta F, Giannini E, Romagnoli P, Fasoli A, Malfatti F, Chiarbonello B, Testa E, Risso D, Colla G, Testa R. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. Gut. 2003;52(1):134–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chalasani N, Kahi C, Francois F, Pinto A, Marathe A, Bini EJ, Pandya P, Sitaraman S, Shen J. Model for end-stage liver disease (MELD) for predicting mortality in patients with acute variceal bleeding. Hepatology. 2002;35(5):1282–4.

    Article  PubMed  Google Scholar 

  • Chawla YK, Kashinath RC, Duseja A, Dhiman RK. Predicting mortality across a broad spectrum of liver disease – an assessment of Model for End-Stage Liver Disease (MELD), Child–Turcotte–Pugh (CTP), and creatinine-modified CTP scores. J Clin Exp Hepatol. 2011;1(3):161–8.

    Article  CAS  PubMed  Google Scholar 

  • Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg. 1964;1:1–85.

    CAS  PubMed  Google Scholar 

  • Cho HC, Jung HY, Sinn DH, Choi MS, Koh KC, Paik SW, Yoo BC, Kim SW, Lee JH. Mortality after surgery in patients with liver cirrhosis: comparison of Child-Turcotte-Pugh, MELD and MELDNa score. Eur J Gastroenterol Hepatol. 2011;23(1):51–9.

    Article  PubMed  Google Scholar 

  • Cholongitas E, Senzolo M, Patch D, Kwong K, Nikolopoulou V, Leandro G, Shaw S, Burroughs AK. Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit. Aliment Pharmacol Ther. 2006;23(7):883–93.

    Article  CAS  PubMed  Google Scholar 

  • Cholongitas E, Marelli L, Kerry A, Goodier DW, Nair D, Thomas M, Patch D, Burroughs AK. Female liver transplant recipients with the same GFR as male recipients have lower MELD scores – ca systematic bias. Am J Transplant. 2007a;7(3):685–92.

    Article  CAS  PubMed  Google Scholar 

  • Cholongitas E, Marelli L, Kerry A, Senzolo M, Goodier DW, Nair D, Thomas M, Patch D, Burroughs AK. Different methods of creatinine measurement significantly affect MELD scores. Liver Transpl. 2007b;13(4):523–9.

    Article  PubMed  Google Scholar 

  • Cucchetti A, Ercolani G, Vivarelli M, Cescon M, Ravaioli M, La Barba G, Zanello M, Grazi GL, Pinna AD. Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. Liver Transpl. 2006;12(6):966–71.

    Article  PubMed  Google Scholar 

  • Cywinski JB, Mascha EJ, You J, Sessler DI, Kapural L, Argalious M, Parker BM. Pre-transplant MELD and sodium MELD scores are poor predictors of graft failure and mortality after liver transplantation. Hep Intl. 2011;5(3):841–9.

    Article  Google Scholar 

  • Dawwas MF, Lewsey JD, Neuberger JM, Gimson AE. The impact of serum sodium concentration on mortality after liver transplantation: a cohort multicenter study. Liver Transpl. 2007;13(8):1115–24.

    Article  PubMed  Google Scholar 

  • Dhiman RK, Jain S, Maheshwari U, Bhalla A, Sharma N, Ahluwalia J, Duseja A, Chawla Y. Early indicators of prognosis in fulminant hepatic failure: an assessment of the Model for End-Stage Liver Disease (MELD) and King’s College Hospital criteria. Liver Transpl. 2007;13(6):814–21.

    Article  PubMed  Google Scholar 

  • Dienstag JL, Ghany MG, Morgan TR, Di Bisceglie AM, Bonkovsky HL, Kim HY, Seeff LB, Szabo G, Wright EC, Sterling RK, Everson GT, Lindsay KL, Lee WM, Lok AS, Morishima C, Stoddard AM, Everhart JE; HALT-C Trial Group. A prospective study of the rate of progression in compensated, histologically advanced chronic hepatitis C. Hepatology. 2011;54(2):396–405. doi:10.1002/hep.24370. Epub 2011 Jun 23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dultz G, Seelhof M, Herrmann E, Welker MW, Friedrich-Rust M, Teuber G, Kronenberger B, von Wagner M, Vermehren J, Sarrazin C, Zeuzem S, Hofmann WP. Baseline MELD score predicts hepatic decompensation during antiviral therapy in patients with chronic hepatitis C and advanced cirrhosis. PLoS One. 2013;8(8):e71262.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dunn W, Jamil LH, Brown LS, Wiesner RH, Kim WR, Menon KV, Malinchoc M, Kamath PS, Shah V. MELD accurately predicts mortality in patients with alcoholic hepatitis. Hepatology. 2005;41(2):353–8.

    Article  PubMed  Google Scholar 

  • Dutkowski P, De Rougemont O, Mullhaupt B, Clavien PA. Current and future trends in liver transplantation in Europe. Gastroenterology. 2010;138(3):802–9. e801–4.

    Article  PubMed  Google Scholar 

  • Dutkowski P, Oberkofler CE, Bechir M, Mullhaupt B, Geier A, Raptis DA, Clavien PA. The model for end-stage liver disease allocation system for liver transplantation saves lives, but increases morbidity and cost: a prospective outcome analysis. Liver Transpl. 2011;17(6):674–84.

    Article  PubMed  Google Scholar 

  • Fattovich G, Giustina G, Degos F, Tremolada F, Diodati G, Almasio P, Nevens F, Solinas A, Mura D, Brouwer JT, Thomas H, Njapoum C, Casarin C, Bonetti P, Fuschi P, Basho J, Tocco A, Bhalla A, Galassini R, Noventa F, Schalm SW, Realdi G. Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients. Gastroenterology. 1997;112(2):463–72.

    Article  CAS  PubMed  Google Scholar 

  • Freeman Jr RB, Edwards EB. Liver transplant waiting time does not correlate with waiting list mortality: implications for liver allocation policy. Liver Transpl. 2000;6(5):543–52.

    Article  PubMed  Google Scholar 

  • Freeman RB, Wiesner RH, Edwards E, Harper A, Merion R, Wolfe R, P. United Network for Organ Sharing Organ, L. Transplantation Network, C. Transplantation. Results of the first year of the new liver allocation plan. Liver Transpl. 2004;10(1):7–15.

    Article  PubMed  Google Scholar 

  • Freeman Jr RB, Gish RG, Harper A, Davis GL, Vierling J, Lieblein L, Klintmalm G, Blazek J, Hunter R, Punch J. Model for end-stage liver disease (MELD) exception guidelines: results and recommendations from the MELD Exception Study Group and Conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula. Liver Transpl. 2006;12(12 Suppl 3):S128–36.

    Article  PubMed  Google Scholar 

  • Freitas AC, Itikawa WM, Kurogi AS, Stadnik LG, Parolin MB, Coelho JC. The impact of the model for end-stage liver disease (MELD) on liver transplantation in one center in Brazil. Arq Gastroenterol. 2010;47(3):233–7.

    Article  PubMed  Google Scholar 

  • Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46(3):922–38.

    Article  CAS  PubMed  Google Scholar 

  • Goldberg D, French B, Abt P, Feng S, Cameron AM. Increasing disparity in waitlist mortality rates with increased model for end-stage liver disease scores for candidates with hepatocellular carcinoma versus candidates without hepatocellular carcinoma. Liver Transpl. 2012;18(4):434–43.

    Article  PubMed  Google Scholar 

  • Goyal SK, Dixit VK, Jain AK, Mohapatra PK, Ghosh JK. Assessment of the Model for End-stage Liver Disease (MELD) score in predicting prognosis of patients with alcoholic hepatitis. J Clin Exp Hepatol. 2014;4(1):19–24.

    Article  PubMed  PubMed Central  Google Scholar 

  • Habib S, Berk B, Chang CC, Demetris AJ, Fontes P, Dvorchik I, Eghtesad B, Marcos A, Shakil AO. MELD and prediction of post-liver transplantation survival. Liver Transpl. 2006;12(3):440–7.

    Article  PubMed  Google Scholar 

  • Hayashi PH, Forman L, Steinberg T, Bak T, Wachs M, Kugelmas M, Everson GT, Kam I, Trotter JF. Model for End-Stage Liver Disease score does not predict patient or graft survival in living donor liver transplant recipients. Liver Transpl. 2003;9(7):737–40.

    Article  PubMed  Google Scholar 

  • Heuman DM, Abou-Assi SG, Habib A, Williams LM, Stravitz RT, Sanyal AJ, Fisher RA, Mihas AA. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology. 2004;40(4):802–10.

    Article  PubMed  Google Scholar 

  • Heuman DM, Mihas AA, Habib A, Gilles HS, Stravitz RT, Sanyal AJ, Fisher RA. MELD-XI: a rational approach to “sickest first” liver transplantation in cirrhotic patients requiring anticoagulant therapy. Liver Transpl. 2007;13(1):30–7.

    Article  PubMed  Google Scholar 

  • Hsu KY, Chau GY, Lui WY, Tsay SH, King KL, Wu CW. Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of Model for End-Stage Liver Disease score. World J Surg. 2009;33(11):2412–9.

    Article  PubMed  Google Scholar 

  • Hsu CY, Lin HC, Huang YH, Su CW, Lee FY, Huo TI, Lee PC, Lee JY, Lee SD. Comparison of the model for end-stage liver disease (MELD), MELD-Na and MELDNa for outcome prediction in patients with acute decompensated hepatitis. Dig Liver Dis. 2010;42(2):137–42.

    Article  CAS  PubMed  Google Scholar 

  • Huo TI, Wu JC, Lin HC, Lee FY, Hou MC, Lee PC, Chang FY, Lee SD. Evaluation of the increase in model for end-stage liver disease (DeltaMELD) score over time as a prognostic predictor in patients with advanced cirrhosis: risk factor analysis and comparison with initial MELD and Child-Turcotte-Pugh score. J Hepatol. 2005;42(6):826–32.

    Article  PubMed  Google Scholar 

  • Huo TI, Lin HC, Hsia CY, Huang YH, Wu JC, Chiang JH, Chiou YY, Lui WY, Lee PC, Lee SD. The MELD-Na is an independent short- and long-term prognostic predictor for hepatocellular carcinoma: a prospective survey. Dig Liver Dis. 2008;40(11):882–9.

    Article  CAS  PubMed  Google Scholar 

  • Jiang M. Comparison of four models for end-stage liver disease in evaluating the prognosis of cirrhosis. World J Gastroenterol. 2008;14(42):6546.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kaiser T, Kinny-Koster B, Bartels M, Parthaune T, Schmidt M, Thiery J. Impact of different creatinine measurement methods on liver transplant allocation. PLoS One. 2014;9(2):e90015.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D’Amico G, Dickson ER, Kim WR. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464–70.

    Article  CAS  PubMed  Google Scholar 

  • Kim WR, Biggins SW, Kremers WK, Wiesner RH, Kamath PS, Benson JT, Edwards E, Therneau TM. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kim MS, Kato TS, Farr M, Wu C, Givens RC, Collado E, Mancini DM, Schulze PC. Hepatic dysfunction in ambulatory patients with heart failure: application of the MELD scoring system for outcome prediction. J Am Coll Cardiol. 2013;61(22):2253–61.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kremers WK, van IJperen M, Kim WR, Freeman RB, Harper AM, Kamath PS, Wiesner RH. MELD score as a predictor of pretransplant and posttransplant survival in OPTN/UNOS status 1 patients. Hepatology. 2004;39(3):764–9.

    Article  PubMed  Google Scholar 

  • Luca A, Angermayr B, Bertolini G, Koenig F, Vizzini G, Ploner M, Peck-Radosavljevic M, Gridelli B, Bosch J. An integrated MELD model including serum sodium and age improves the prediction of early mortality in patients with cirrhosis. Liver Transpl. 2007;13(8):1174–80.

    Article  PubMed  Google Scholar 

  • Lucey MR, Brown KA, Everson GT, Fung JJ, Gish R, Keeffe EB, Kneteman NM, Lake JR, Martin P, McDiarmid SV, Rakela J, Shiffman ML, So SK, Wiesner RH. Minimal criteria for placement of adults on the liver transplant waiting list: a report of a national conference organized by the American Society of Transplant Physicians and the American Association for the Study of Liver Diseases. Liver Transpl Surg. 1997 Nov;3(6):628–37.

    Google Scholar 

  • Maddrey WC, Boitnott JK, Bedine MS, Weber Jr FL, Mezey E, White Jr RI. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978;75(2):193–9.

    CAS  PubMed  Google Scholar 

  • Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31(4):864–71.

    Article  CAS  PubMed  Google Scholar 

  • Massie AB, Caffo B, Gentry SE, Hall EC, Axelrod DA, Lentine KL, Schnitzler MA, Gheorghian A, Salvalaggio PR, Segev DL. MELD exceptions and rates of waiting list outcomes. Am J Transplant. 2011;11(11):2362–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Massie AB, Chow EKH, Wickliffe CE, Luo X, Gentry SE, Mulligan DC, Segev DL. Early changes in liver distribution following implementation of share 35. Am J Transplant. 2015;15(3):659–67.

    Article  CAS  PubMed  Google Scholar 

  • Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334(11):693–9.

    Article  CAS  PubMed  Google Scholar 

  • Menon KV, Gores GJ, Shah VH. Pathogenesis, diagnosis, and treatment of alcoholic liver disease. Mayo Clin Proc. 2001;76(10):1021–9.

    Article  CAS  PubMed  Google Scholar 

  • Merion RM, Schaubel DE, Dykstra DM, Freeman RB, Port FK, Wolfe RA. The survival benefit of liver transplantation. Am J Transplant. 2005;5(2):307–13.

    Article  PubMed  Google Scholar 

  • Northup PG, Wanamaker RC, Lee VD, Adams RB, Berg CL. Model for End-Stage Liver Disease (MELD) predicts nontransplant surgical mortality in patients with cirrhosis. Ann Surg. 2005;242(2):244–51.

    Article  PubMed  PubMed Central  Google Scholar 

  • Oberkofler CE, Dutkowski P, Stocker R, Schuepbach RA, Stover JF, Clavien PA, Bechir M. Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipients. Crit Care. 2010;14(3):R117.

    Article  PubMed  PubMed Central  Google Scholar 

  • Organ Procurement and Transplantation Network. Health Resources and Services Administration, HHS. Final rule. [No authors listed]. Fed Regist. 1999 Oct 20;64(202):56650-61

    Google Scholar 

  • Ostapowicz G, Lee WM. Acute hepatic failure: a western perspective. J Gastroenterol Hepatol. 2000;15(5):480–8.

    Article  CAS  PubMed  Google Scholar 

  • Papatheodoridis GV, Cholongitas E, Dimitriadou E, Touloumi G, Sevastianos V, Archimandritis AJ. MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis. World J Gastroenterol. 2005;11(20):3099–104.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pomfret EA, Fryer JP, Sima CS, Lake JR, Merion RM. Liver and intestine transplantation in the United States, 1996–2005. Am J Transplant. 2007;7(5 Pt 2):1376–89.

    Article  CAS  PubMed  Google Scholar 

  • Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646–9.

    Article  CAS  PubMed  Google Scholar 

  • Quante M, Benckert C, Thelen A, Jonas S. Experience since MELD implementation: how does the new system deliver? Int J Hepatol. 2012;2012:264015.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ruf AE, Kremers WK, Chavez LL, Descalzi VI, Podesta LG, Villamil FG. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transpl. 2005;11(3):336–43.

    Article  PubMed  Google Scholar 

  • Said A, Williams J, Holden J, Remington P, Gangnon R, Musat A, Lucey MR. Model for end stage liver disease score predicts mortality across a broad spectrum of liver disease. J Hepatol. 2004;40(6):897–903.

    Article  PubMed  Google Scholar 

  • Santori G, Andorno E, Morelli N, Antonucci A, Bottino G, Mondello R, Castiglione AG, Valente R, Ravazzoni F, Di Domenico S, Valente U. MELD score versus conventional UNOS status in predicting short-term mortality after liver transplantation. Transpl Int. 2005;18(1):65–72.

    Article  PubMed  Google Scholar 

  • Schmidt LE, Larsen FS. MELD score as a predictor of liver failure and death in patients with acetaminophen-induced liver injury. Hepatology. 2007;45(3):789–96.

    Article  CAS  PubMed  Google Scholar 

  • Schouten JN, Francque S, Van Vlierberghe H, Colle I, Nevens F, Delwaide J, Adler M, Starkel P, Ysebaert D, Gadisseur A, De Winter B, Smits JM, Rahmel A, Michielsen P. The influence of laboratory-induced MELD score differences on liver allocation: more reality than myth. Clin Transplant. 2012;26(1):E62–70.

    Article  CAS  PubMed  Google Scholar 

  • Sharma P, Balan V, Hernandez JL, Harper AM, Edwards EB, Rodriguez-Luna H, Byrne T, Vargas HE, Mulligan D, Rakela J, Wiesner RH. Liver transplantation for hepatocellular carcinoma: the MELD impact. Liver Transpl. 2004;10(1):36–41.

    Article  PubMed  Google Scholar 

  • Sharma P, Schaubel DE, Gong Q, Guidinger M, Merion RM. End-stage liver disease candidates at the highest model for end-stage liver disease scores have higher wait-list mortality than status-1A candidates. Hepatology. 2012;55(1):192–8.

    Article  PubMed  Google Scholar 

  • Srikureja W, Kyulo NL, Runyon BA, Hu KQ. MELD score is a better prognostic model than Child-Turcotte-Pugh score or discriminant function score in patients with alcoholic hepatitis. J Hepatol. 2005;42(5):700–6.

    Article  PubMed  Google Scholar 

  • Teh SH, Nagorney DM, Stevens SR, Offord KP, Therneau TM, Plevak DJ, Talwalkar JA, Kim WR, Kamath PS. Risk factors for mortality after surgery in patients with cirrhosis. Gastroenterology. 2007;132(4):1261–9.

    Article  PubMed  Google Scholar 

  • Toshikuni N, Izumi A, Nishino K, Inada N, Sakanoue R, Yamato R, Suehiro M, Kawanaka M, Yamada G. Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus-related cirrhosis. J Gastroenterol Hepatol. 2009;24(7):1276–83.

    Article  PubMed  Google Scholar 

  • Trotter JF, Brimhall B, Arjal R, Phillips C. Specific laboratory methodologies achieve higher model for end-stage liver disease (MELD) scores for patients listed for liver transplantation. Liver Transpl. 2004;10(8):995–1000.

    Article  PubMed  Google Scholar 

  • Trotter JF, Olson J, Lefkowitz J, Smith AD, Arjal R, Kenison J. Changes in international normalized ratio (INR) and model for end-stage liver disease (MELD) based on selection of clinical laboratory. Am J Transplant. 2007;7(6):1624–8.

    Article  CAS  PubMed  Google Scholar 

  • van Deursen VM, Damman K, Hillege HL, van Beek AP, van Veldhuisen DJ, Voors AA. Abnormal liver function in relation to hemodynamic profile in heart failure patients. J Card Fail. 2010;16(1):84–90.

    Article  PubMed  Google Scholar 

  • Villanueva C, Piqueras M, Aracil C, Gomez C, Lopez-Balaguer JM, Gonzalez B, Gallego A, Torras X, Soriano G, Sainz S, Benito S, Balanzo J. A randomized controlled trial comparing ligation and sclerotherapy as emergency endoscopic treatment added to somatostatin in acute variceal bleeding. J Hepatol. 2006;45(4):560–7.

    Article  PubMed  Google Scholar 

  • Wagener G, Raffel B, Young AT, Minhaz M, Emond J. Predicting early allograft failure and mortality after liver transplantation: the role of the postoperative model for end-stage liver disease score. Liver Transpl. 2013;19(5):534–42.

    Article  PubMed  Google Scholar 

  • Washburn K, Edwards E, Harper A, Freeman R. Hepatocellular carcinoma patients are advantaged in the current liver transplant allocation system. Am J Transplant. 2010;10(7):1643–8.

    Article  CAS  PubMed  Google Scholar 

  • Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, Kremers W, Lake J, Howard T, Merion RM, Wolfe RA, Krom R, C. United Network for Organ Sharing Liver Disease Severity Score. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124(1):91–6.

    Article  PubMed  Google Scholar 

  • Yang JA, Kato TS, Shulman BP, Takayama H, Farr M, Jorde UP, Mancini DM, Naka Y, Schulze PC. Liver dysfunction as a predictor of outcomes in patients with advanced heart failure requiring ventricular assist device support: use of the Model of End-stage Liver Disease (MELD) and MELD eXcluding INR (MELD-XI) scoring system. J Heart Lung Transplant. 2012;31(6):601–10.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yantorno SE, Kremers WK, Ruf AE, Trentadue JJ, Podesta LG, Villamil FG. MELD is superior to King’s college and Clichy’s criteria to assess prognosis in fulminant hepatic failure. Liver Transpl. 2007;13(6):822–8.

    Article  PubMed  Google Scholar 

  • Yao FY, Bass NM, Ascher NL, Roberts JP. Liver transplantation for hepatocellular carcinoma: lessons from the first year under the Model of End-Stage Liver Disease (MELD) organ allocation policy. Liver Transpl. 2004;10(5):621–30.

    Article  PubMed  Google Scholar 

  • Ziser A, Plevak DJ, Wiesner RH, Rakela J, Offord KP, Brown DL. Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology. 1999;90(1):42–53.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Liver Diseases and Recanati-Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1104, New York, NY, 10029, USA

    Deepika Devuni & Jawad Ahmad

Authors
  1. Deepika Devuni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jawad Ahmad
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jawad Ahmad .

Editor information

Editors and Affiliations

  1. Department of Biomedical Science, Faculty of Science and Technology, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Diabetes and Nutritional Sciences Research Division, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Science+Business Media Dordrecht

About this entry

Cite this entry

Devuni, D., Ahmad, J. (2017). Model for End-Stage Liver Disease (MELD) Score as a Biomarker. In: Patel, V., Preedy, V. (eds) Biomarkers in Liver Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7675-3_30

Download citation

Publish with us

Policies and ethics

Search

Navigation