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Model for End-Stage Liver Disease (MELD) is a numerical score based on a patient’s risk of dying while waiting for a liver transplant; mortality at 90 days for alcoholic hepatitis can also be used to guide in treatment decisions in patients with alcoholic hepatitis, especially if complicated by ascites and/or encephalopathy. The maximum serum creatinine considered within the MELD score is 350 µmol/L; if a patient has had dialysis more than twice in the past week or has a Cr > 350 µmol/L, then the maximum value will be entered.
A MELD score of >18 is considered high risk. Patients with a MELD score of >14 had a median survival of <90 days with insertion of TIPSS.
References
Angermayr B et al. Child Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt. Gut 2003; 52(6) : 879-85.
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Schepke M et al. Comparison of MELD, Child-Pugh, and Emory Model for the prediction of survival in patients undergoing transjugular intrahepatic portosystemic shunting. Am J Gastro 2003; 98 : 1167-74
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