MELD Refit

Model for End-Stage Liver Disease (MELD) Refit

On Dialysis :
Creatinine :
Total Bilirubin:
INR :

The Model for End-Stage Liver Disease (MELD) is a reliable measure of mortality risk in patients with end-stage liver disease. It is used as a disease severity index to help prioritize allocation of organs for transplant.

The Refit model looks to optimize prediction of mortality with alteration of factors including change in allowable boundaries for labs.

Formula :

4.082[Ln serum bilirubin (mg/dL)] + 10.671[Ln INR] + 8.485[Ln serum creatinine (mg/dL)] + 7.432

Explanation of Result :

3 Month Mortality :MELD score > 40 : 71.3% mortality
MELD score 30–39 : 52.6% mortality
MELD score 20–29 : 19.6% mortality
MELD score 10–19 : 6.0% mortality
MELD score < 9 : 1.9% mortality

* Please verify all calculations prior to clinical use.

References

  • Kamath PS, Kim WR; Advanced Liver Disease Study Group. The model for end-stage liver disease (MELD). Hepatology. 2007 Mar;45(3):797-805. PMID: 17326206.
  • Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, Kremers W, Lake J, Howard T, Merion RM, Wolfe RA, Krom R; United Network for Organ Sharing Liver Disease Severity Score Committee. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003 Jan;124(1):91-6. PMID: 12512033.
  • Leise MD, Kim WR, Kremers WK, Larson JJ, Benson JT, Therneau TM. A revised model for end-stage liver disease optimizes prediction of mortality among patients awaiting liver transplantation. Gastroenterology. 2011 Jun;140(7):1952-60. PMID: 21334338.