Cystic fibrosis with FEV1 (forced expiratory volume in 1 second)

Primary hyperoxaluria with evidence of alanine glyoxylate aminotransferase deficiency (these patients requires combined liver-kidney transplantation).

Familial amyloid polyneuropathy, as diagnosed by identification of the transthyretin (TTR) gene mutation by DNA analysis or mass spectrometry in a biopsy sample and confirmation of amyloid deposition in an involved organ.

Hepatic artery thrombosis 7–14 days post-liver transplantation.

Hepatocellular carcinoma (HCC) with one lesion between 2 – 5 cm or two to three lesions 25 mmHg at rest but maintained <35 mmHg with treatment.

The following conditions are automatically assigned a MELD Score of 22 (28 in case of hyperoxaluria), with a 10% increase in score every 3 months from diagnosis. Several conditions are “standard MELD exclusions” and receive a different score: MELD can be used on any patient with end stage liver disease irrespective of cirrhosis etiology.Ĭurrently, there is no modification in the score for patients on anticoagulation (given their INR may be elevated). Values should be no more than 48 hours old. The MELD was updated in January 2016 and now includes serum sodium level. MELD Score should be periodically re-assessed, as it changes with changing lab values.Īll cirrhosis patients should be periodically screened for hepatocellular carcinoma with serum alpha-fetoprotein (AFP) and by appropriate imaging to see if they can earn “standard MELD exceptions”.

24 hours of continuous veno-venous hemodialysis (CVVHD) within the prior 7 days.Ĭonsider referral to hepatologist or liver transplant center for patients with MELD Score ≥10.

≥2 dialysis treatments within the prior 7 days.

If MELD(i) > 11, perform additional MELD calculation as follows: Then, round to the tenth decimal place and multiply by 10. Scores range from 6 to 40, with higher scores correlating with increased severity of liver dysfunction and higher three-month mortality.Ĭandidates who are at least 12 years old receive an initial MELD(i) score equal to:

Dialysis on at least two occasions in the last week or continuous veno-venous hemodialysis for ≥24 hours in the last week.The MELD (Model for End-Stage Liver Disease) score is based on the assessment of the following parameters: The MELD score also predicts three-month survival in patients (age 12+) with cirrhosis. (b) cirrhotic patients undergoing non-transplantation surgical procedures.(a) after transjugular intrahepatic portosystemic shunt (TIPS).Predicts mortality in the following scenarios:.MELD score used to stratify patients ≥12 years old on liver transplant waiting lists.

Optn meld calculator