Understanding the MELD Score for Liver Transplant Patients

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Doctor and Patient

If you or a loved one have been recommended by your liver specialist for a liver transplant, understanding the MELD score will give you helpful information.

After going through an evaluation process that includes a wide range of tests and procedures you will meet with a liver transplant team to discuss your condition and put on a liver transplant waiting list.  This list is maintained by the UNOS (United Network for Organ Sharing).

 

Determining who gets a liver is based on a formula that takes into consideration lab values such as, creatinine, total bilirubin, and INR.  UNOS will then assign a MELD score based upon these values.

 

The higher the MELD score the sicker the patient, and the higher on the transplant waiting list. UT Southwest Medicine reports livers are only matched for blood type (A, B, O, AB) and size.  Unlike other organs, special tissue typing is not necessary to determine which liver donor makes the best match.

 

The MELD score assigned to each liver transplant patient is re-assessed and re-certified. MELD scores range from 0-40 or greater.  On the waiting list, all liver patients and their MELD scores are reassessed and re-certified on a frequent basis.
In this video, Dr. Joe Galati, a Liver Specialist in Houston, discusses how the MELD score is calculated, and how MELD exception points are calculated. Dr. Galati is affiliated with Liver Specialists of Texas and the Center for Liver Disease and Transplantation at The Methodist Hospital in Houston, Texas, a leading liver transplant center in the United States. The Methodist Hospital is the largest liver transplant center in Texas, and one of the largest in the United States.

 

The MELD score is calculated by determining the patients bilirubin, creatinine, and INR. The MELD score ranges from 5-40. The higher the MELD score, the more advanced the liver disease is, and the sooner the patient will be allocated a liver for transplant.

 

 

Very helpful articles and videos to understand more about liver transplants and the steps for evaluation include:

 

  1. John Hopkins Medicine. www.hopkinsmedicine.org
  2. The Washington University and Barnes -Jewish Hospital Liver Transplant Program. www.barnes-jewish.org/before-liver-transplant
  3. University of California San Francisco Medical Center: Liver Transplant Program. http://www.ucsfhealth.org/conditions/liver_transplant/signs_and_symptoms.html
  4. Liver Specialist of Texas/Dr. Joseph Galati M.D.:  www.texasliver.com
  5. Methodist J.C. Walter Transplant Center :  www.methodisthealth.com  or http://houstonmethodist15-px.rtrk.com/mtc.cfm?id=35448
  6. .UT Southwest Medical: http://www.utswmedicine.org/conditions-specialties/transplant/programs/liver/
  7. American Liver Foundation: http://www.liverfoundation.org/abouttheliver/info/transplant/
  8. Mayo Clinic Transplant Information and Hospitals

 

Do you have questions about a liver transplant?

Share your comments below.

 

To view this post or other resources, see our home page at, Life Beyond Hep C.

 

Related Posts:

 

4 Key Dietary Steps for Hep C and Liver Disease.

 

 

 

 

 

The Importance of Taking Cirrhosis Medication; Hep C Patient Interview with Suzanne and Mark, part 1.

 

 

 

 

 The Importance of Taking Cirrhosis Medication; Hep C Patient Interview with Suzanne and Mark, part 2.

 

 

 

 

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18 Responses to Understanding the MELD Score for Liver Transplant Patients

  1. Margaret Polino Nicholas January 28, 2014 at 4:23 am #

    I have wondered about the MELD score. Thanks for the information.
    Warrior margee

    • Connie M January 28, 2014 at 4:26 am #

      Margee,
      You are so welcome.
      Keep me posted on your doctor’s appt.

      Your in my thoughts & prayers,
      Blessings friend,
      Connie

  2. J.D. Worley January 28, 2014 at 8:43 am #

    Hello Warriors, well I know a lot about the MELD score as I have had to go through the whole process and I am now post transplant.
    I wanted to comment to anyone who may be blood type AB, I discovered that it can be a blessing to be an AB bloodtype is you are waiting for a new liver.
    I am AB+ and I was on the list only 8 days expecting it to take up to 4 months, but God was watching out for me!
    I found out it was due to my bloodtype which I could do a whole blog and Bible lesson on how important blood types are in the Bible.
    So I won’t bore you with all of that now.
    In North Carolina where I was registered an AB bloodtype can receive a liver from any other blood type however an AB donor liver can only go to an AB recepient!
    Enter GOD and a major MIRACLE in my life!
    I was the only AB+ reciepeint on the list in NC!
    tada I got the liver!!! God is not good HE IS GREAT!!!
    Later on of the surgeons told my wife that that liver had my name on it because they found 2 cancerous tumors in my old liver and they were growing rapidly!!
    I was moved up on the MELD score list when the found the first cancerous tumor and was put at the front of the line so to speak but then when the donor liver came through that was from an AB blood type that sealed the Miracle God had planned for me from eternity past!!!
    So be encouraged anyone who is waiting for about to be put on a waiting list for transplant it’s not over till it’s over and with Christ it’s not over even then!

    And that’s the truth
    J.D.

    • Connie M January 28, 2014 at 11:16 am #

      J.D.
      Thank you very much for commenting and sharing this valuable information. Wow! This was very informative and encouraging. There is nothing like hearing from someone who has already come through the valley. Thanks J.D.! God is using you in a mighty way as His instrument to speak encouragement and hope to others. Bless you my friend.

      Many Blessings~
      Connie

  3. Susan Vaughn January 28, 2014 at 5:29 pm #

    …..please speak to the actual MELD Score number (e.g. how high the number must get to) relative to the number of available organs associated in the geographic area of a transplant program…

    • Connie M January 28, 2014 at 5:49 pm #

      Hi Susan,
      The actual MELD score can range as high as 40, but according to UNOS. Patients are re-evaluated on a regular basis, so each patients MELD score number can change very often. As to the comparing that number to available organs associated in a geographic area of a transplant program, that is a moving target. No one knows the availability of organs in the case of a liver (due to death must occur for someone in order for total transplant to be given to a liver transplant patient).

      We are seeing more success with living transplants that involve partial liver transplants. But as to MELD score requirements in relation to those patients receiving partial transplant, the transplant physician and hepatologist would know those answers.

      As in J.D’s case, his blood type and the receiving liver donor’s blood type was a factor, along with his MELD score.

      Thanks for asking this question Susan. If you need further information I can refer you to some resources and links. Let me know if I can help.

      Blessings,
      Connie

    • J.D. January 29, 2014 at 8:40 am #

      Susan I think it must be a 14 before you can be referred to a transplant doctor or center at least that is when my doctor referred me.
      Then when they found the cancer I got put up to 21 which is like “needs liver urgently”.
      Hope this will help you but it would be better to ask your doctor they will be able to better explain it to you.

      J.D.

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  5. Richard May 10, 2014 at 6:03 am #

    I was originally diagnosed with a meld of 21 by a hospital now out of business (bankruptcy/mal-practice suits) and after working my butt off I have survived. I go to a highly ranked transplant hospital in NY and my meld bounces between 7 and 8. What is considered normal? I know 0 would be the best answer but what category does my current meld put me in. BTW, The lesion has completely disappeared as of 2.5 years ago.

    Thank you
    Richard

    • Connie M May 28, 2014 at 5:00 pm #

      Hi Richard,
      I am so sorry to hear you have had to go through so much with this other hospital and difficulty with Hep C. I know MELD scores do take into account a lot of different factors. If your MELD score is below 10 it is considered a low number. Here is a reliable article that can better explain in more detail about MELD scores;
      http://www.cpmc.org/advanced/liver/patients/topics/MELD.html#What is the average MELD score for a patient undergoing transplant?

      If you have had a lesion that has disappeared that is great news!
      Hope you find this article helpful.
      If you have further questions or need information, feel free to let me know.

      You are in my prayers.
      Blessings,
      Connie

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  8. Dillon September 26, 2014 at 3:55 am #

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      Hi Dillion,
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      Blessings,
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  9. Richard s. March 15, 2017 at 3:03 pm #

    Good afternoon warriors, I didn’t know JD was AB. He is blessed to have this blood type. There were only two people on the list in Florida with this blood type when I was waiting for my transplant. Both my parents were AB. I am B. The Lord works in mysterious ways. In Christ ,Richard s.

    • Connie M March 15, 2017 at 4:28 pm #

      Hi Richard,
      Thanks for sharing this afternoon. You as well as J.D. and Hernando and so many others who have come through liver transplant are special Hep C Hero’s. I have always appreciated your input and encouragement to patients who are waiting the transplant list. We always need to hear from others who have gone through it. Hope with skin on folks are inspiring to others. You my friend are hope with skin on! Thanks for being here.

      Blessings my friend,
      Connie

  10. Richard s. March 15, 2017 at 5:30 pm #

    Thanks Connie, you my friend are a blessing to all, Richard s.

    • Connie M March 15, 2017 at 5:34 pm #

      Hi Richard,
      It’s an honor to serve with you my friend.
      Blessings,
      Connie

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