Forum FeedbackMELD is not enough—enough of MELD?
References (15)
MELD: the holy grail of organ allocation?
J Hepatol
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Normalised intrinsic mortality risk in liver transplantation: European Liver Transplant Registry study
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Preoperative delta-MELD score does not independently predict mortality after liver transplantation
Am J Transpl
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Utility of the MELD score for assessing 3-month survival in patients with liver cirrhosis: one more positive answer
Gastroenterology
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Is MELD really the definitive score for liver allocation?
Liver Transpl
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Assessing renal function in cirrhotic patients: problems and pitfalls
Am J Kidney Dis
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Model for end stage liver disease score predicts mortality across a broad spectrum of liver disease
J Hepatol
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Cited by (22)
Validation of a Model for Identification of Patients With Compensated Cirrhosis at High Risk of Decompensation
2019, Clinical Gastroenterology and HepatologyMultivariate metabotyping of plasma predicts survival in patients with decompensated cirrhosis
2016, Journal of HepatologyCitation Excerpt :The Model for End-Stage Liver Disease (MELD) is the most commonly applied and is used for listing and prioritisation in liver transplantation throughout the world. Despite the success of MELD, several limitations exist concerning the reproducibility of prothrombin time measurement and the limitations of creatinine [4] as a marker of renal function in patients with cirrhosis. The performance of MELD for outcome prediction is best in patients with stable cirrhosis, but is less accurate for patients with acute on chronic liver failure (ACLF) [5].
External validation and comparison of six prognostic models in a prospective cohort of HBV-ACLF in china
2016, Annals of HepatologyCitation Excerpt :MELD score system was adopted as the standard by which to determine the priority to allocate cadaveric livers to transplant candidates in February 2002 in USA and in many other countries thereafter.9 Meanwhile, several studies showed that certain subsets of patients with advanced liver disease may have high mortality in spite of low MELD scores.10 Thus, a number of attempts, including replacement of some MELD components, re-assignment of weights for existing components, incorporation of other variables into the model, were explored to improve the prognostic accuracy of this model, leading to several MELD-based models such as MELD sodium (MELD-Na),11,12 MELD to sodium ratio (MESO),13 integrated MELD (iMELD),14 updated MELD (uMELD),15 United Kingdom MELD (UKMELD)16 and donor MELD (D-MELD).17
Child-Turcotte score versus MELD for prognosis in a randomized controlled trial of emergency treatment of bleeding esophageal varices in cirrhosis
2012, Journal of Surgical ResearchCitation Excerpt :By and large, these studies have failed to demonstrate superiority of MELD over C-T-P. In a review of reported studies of patients in non-transplant settings, Cholangitas and associates [24,25] reported that, in TIPS studies involving 1,360 cirrhotic patients, only one of five studies showed MELD to be superior to C-T-P in predicting 3-mo mortality, and in that study MELD was not superior to C-T-P in predicting 12-mo mortality. Furthermore, in four studies that involved 2,569 cirrhotic patients, none showed a significant difference between MELD and C-T-P for either short- or long-term prognosis, and no differences existed in predicting variceal bleeding in 411 patients.
Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure
2012, Digestive and Liver DiseaseCitation Excerpt :Although, the CTP score had the lowest efficiency (AUC = 0.66) and incorporates subjective variables, it is simpler than the other three scores. It remains a convenient scoring system with acceptable discriminative power and could be improved by the addition of serum creatinine values [23,24]. As far as causes of mortality are concerned, in our study 77% patients died because of multi-organ failure.