Meld score prognosis full#

During this period, a total of 560 patients were listed for transplantation. This is a single‐centre retrospective cohort study of all adult patients with cirrhosis listed for liver transplantation at the Hospital Clínic of Barcelona during the period between January 2000 and March 2005. The purpose of this study was to investigate these issues. However, there are several issues on the possible use of serum sodium as a predictor of prognosis that require more information, specifically: (1) whether the value of serum sodium is equally effective in the assessment of short‐term prognosis (3 months) compared with mid‐term prognosis (12 months) (2) whether serum sodium is equally accurate in predicting prognosis in different subpopulations of patients with cirrhosis and (3) whether serum sodium improves the accuracy of the MELD score. 8, 9, 10 According to the results of these studies, the use of serum sodium in the assessment of severity of cirrhosis has been recommended. In this regard, several recent studies have shown that serum sodium concentration is a good marker of prognosis in patients awaiting transplantation. 4, 5, 6, 7 Therefore, there is need for improvement of the MELD score. Nevertheless, several studies, as well as clinical observation, indicate that some subsets of patients with cirrhosis may have high mortality despite low MELD scores. 1, 2, 3 This model, which includes variables related to both liver and renal function, was implemented in the USA in 2002 and is currently being used in many countries to classify patients with cirrhosis awaiting transplantation according to the severity of their liver disease.

The high negative predictive value of MELD score may allow it to be used in conjunction with KCH criteria to avoid unneeded LT in patients who will likely recover spontaneously.The model for end‐stage liver disease (MELD) score is the method most widely used for organ allocation in liver transplantation. However, the high false-positive rate associated with MELD limits its clinical utility. MELD has higher sensitivity and negative predictive value for POD-induced ALF than the KCH criteria. Sensitivity and negative predictive value of MELD was higher then KCH however, we found KCH to have much higher specificity and positive predictive value. Sixty five percent of patients had a MELD > 30 and therefore could potentially be listed on admission however, using KCH criteria only 24% patients were listed immediately. Thirty-one patients (43%) recovered with medical therapy, 29 (40%) patients died, and 12 (17%) underwent LT.

Meld score prognosis full#

Outcomes were defined as LT, death, or full recovery. The effect of applying a MELD score of greater than 30 as listing criteria for LT was calculated and compared with the KCH criteria. Clinical and biochemical parameters were recorded.

Seventy-two patients (average age 38 years F:M ratio 2:1) admitted from 1994 to 2005 with POD-related ALF were studied. This study compares prognostic accuracy of the two systems in patients with paracetamol (POD)-induced ALF treated in this unit. Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). The King's College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT).