Application and Significance of MELD Scoring System in Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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XIE Jianguo , YAN Lnan.

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Model for end-stage liver disease Liver transplantation Organ sharing

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【Abstract】Objective To introduce the birth and development of model of endstage liver disease (MELD) and evaluate its effect on liver transplantation(LT) as a new scoring system.
Methods Literatures of MELD applied in LT were analyzed retrospectively.
Results MELD scoring system was used for predicting the prognosis of patients with endstage liver disease and the death risk of candidates on waiting LT extensively and the order of organ sharing was determined by its predicable results.
Conclusion MELD has been had a successful initial implementation for predicting the shortterm survival probability and mortality in patients with endstage liver disease, and meeting the goal of providing a system of allocation that emphasizes the urgency of the candidate while diminishing the reliance on waiting time, which has been proven to be a powerful tool for auditing the liver allocation system.

Citation： XIE Jianguo,YAN Lnan.. Application and Significance of MELD Scoring System in Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(6): 634-636. doi: Copy

1.	Testa R, Valente U, Risso D, et al. Can the MEGX test and serum bile acids improve the prognostic ability of ChildPugh’s score in liver cirrhosis? [J]. Eur J Gastroenterol Hepatol, 1999; 11(5)559.
2.	Malinchoc M, Kamath PS, Gordon FD, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts [J]. Hepatology, 2000; 31(4)864.
3.	Chalasani N, Kahi CJ, Francois F, et al. Mayo clinic endstage liver disease model (MELD) for predicting patient outcomes following acute variceal bleeding [J]. Hepatology, 2001； 34∶345A.
4.	Carithers RL Jr. Liver transplantation. American Association for the Study of Liver Diseases [J]. Liver Transpl, 2000; 6(1)122.
5.	Abouassi SG, Mihas AA, Williams LM, et al. MELD and CTP scores are equivalent predictors of mortality in cirrhotic veterans referred for orthotopic liver transplantation (OLT) [J]. Hepatology, 2001; 34207A.
6.	Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with endstage liver disease [J]. Hepatology, 2001; 33(2)464.
7.	Bambha K, Kim WR, Kremers WK, et al. Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurements [J]. Am J Transplant, 2004; 4(11)1798.
8.	Wiesner RH, McDiarmid SV, Kamath PS, et al. MELD and PELD: application of survival models to liver allocation [J]. Liver Transpl, 2001; 7(7)567.
9.	Botta F, Giannini E, Romagnoli P, et al. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study [J]. Gut, 2003; 52(1)134.
10.	Freeman RB Jr, Wiesner RH, Roberts JP, et al. Improving liver allocation: MELD and PELD [J]. Am J Transplant, 2004; 4(Suppl 9)114.
11.	Freeman RB, Wiesner RH, Edwards E, et al. Results of the first year of the new liver allocation plan [J]. Liver Transpl, 2004; 10(1)7.
12.	Jacob M, Copley LP, Lewsey JD, et al. Pretransplant MELD score and post liver transplantation survival in the UK and Ireland [J]. Liver Transpl, 2004; 10(7)903.
13.	Onaca NN, Levy MF, Sanchez EQ, et al. A correlation between the pretransplantation MELD score and mortality in the first two years after liver transplantation [J]. Liver Transpl, 2003; 9(2)117.
14.	Bambha K, Kim WR, Kremers WK, et al. Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurements [J]. Am J Transplant, 2004; 4(11)1798.
15.	Wiesner RH, Freeman RB, Mulligan DC. Liver transplantation for hepatocellular cancer: the impact of the MELD allocation policy [J]. Gastroenterology, 2004; 127(5 Suppl 1)S261.
16.	Sharma P, Balan V, Hernandez JL, et al. Liver transplantation for hepatocellular carcinoma: the MELD impact [J]. Liver Transpl, 2004; 10(1)36.
17.	Yao FY, Bass NM, Ascher NL, et al. Liver transplantation for hepatocellular carcinoma: lessons from the first year under the Model of EndStage Liver Disease (MELD) organ allocation policy [J]. Liver Transpl, 2004; 10(5)621.
18.	Olthoff KM, Brown RS Jr, Delmonico FL, et al. Summary report of a national conference: Evolving concepts in liver allocation in the MELD and PELD era. December 8, 2003, Washington, DC, USA [J]. Liver Transpl, 2004; 10(10 Suppl 2)A6.
19.	Wang VS, Saab S. Liver transplantation in the era of model for endstage liver disease [J]. Liver Int, 2004; 24(1)1.
20.	Trotter JF, Brimhall B, Arjal R, et al. Specific laboratory methodologies achieve higher model for endstage liver disease (MELD) scores for patients listed for liver transplantation [J]. Liver Transpl, 2004; 10(8)995.
21.	McCaughan GW, Strasser SI. To MELD or not to MELD? [J]. Hepatology， 2001; 34(1)215.
22.	Heuman DM, AbouAssi SG, Habib A, et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death [J]. Hepatology， 2004; 40(4)802.
23.	Freeman RB. Mathematical models and behavior: assessing delta MELD for liver allocation [J]. Am J Transplant， 2004; 4(11)1735.

1. Testa R, Valente U, Risso D, et al. Can the MEGX test and serum bile acids improve the prognostic ability of ChildPugh’s score in liver cirrhosis? [J]. Eur J Gastroenterol Hepatol, 1999; 11(5)559.
2. Malinchoc M, Kamath PS, Gordon FD, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts [J]. Hepatology, 2000; 31(4)864.
3. Chalasani N, Kahi CJ, Francois F, et al. Mayo clinic endstage liver disease model (MELD) for predicting patient outcomes following acute variceal bleeding [J]. Hepatology, 2001； 34∶345A.
4. Carithers RL Jr. Liver transplantation. American Association for the Study of Liver Diseases [J]. Liver Transpl, 2000; 6(1)122.
5. Abouassi SG, Mihas AA, Williams LM, et al. MELD and CTP scores are equivalent predictors of mortality in cirrhotic veterans referred for orthotopic liver transplantation (OLT) [J]. Hepatology, 2001; 34207A.
6. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with endstage liver disease [J]. Hepatology, 2001; 33(2)464.
7. Bambha K, Kim WR, Kremers WK, et al. Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurements [J]. Am J Transplant, 2004; 4(11)1798.
8. Wiesner RH, McDiarmid SV, Kamath PS, et al. MELD and PELD: application of survival models to liver allocation [J]. Liver Transpl, 2001; 7(7)567.
9. Botta F, Giannini E, Romagnoli P, et al. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study [J]. Gut, 2003; 52(1)134.
10. Freeman RB Jr, Wiesner RH, Roberts JP, et al. Improving liver allocation: MELD and PELD [J]. Am J Transplant, 2004; 4(Suppl 9)114.
11. Freeman RB, Wiesner RH, Edwards E, et al. Results of the first year of the new liver allocation plan [J]. Liver Transpl, 2004; 10(1)7.
12. Jacob M, Copley LP, Lewsey JD, et al. Pretransplant MELD score and post liver transplantation survival in the UK and Ireland [J]. Liver Transpl, 2004; 10(7)903.
13. Onaca NN, Levy MF, Sanchez EQ, et al. A correlation between the pretransplantation MELD score and mortality in the first two years after liver transplantation [J]. Liver Transpl, 2003; 9(2)117.
14. Bambha K, Kim WR, Kremers WK, et al. Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurements [J]. Am J Transplant, 2004; 4(11)1798.
15. Wiesner RH, Freeman RB, Mulligan DC. Liver transplantation for hepatocellular cancer: the impact of the MELD allocation policy [J]. Gastroenterology, 2004; 127(5 Suppl 1)S261.
16. Sharma P, Balan V, Hernandez JL, et al. Liver transplantation for hepatocellular carcinoma: the MELD impact [J]. Liver Transpl, 2004; 10(1)36.
17. Yao FY, Bass NM, Ascher NL, et al. Liver transplantation for hepatocellular carcinoma: lessons from the first year under the Model of EndStage Liver Disease (MELD) organ allocation policy [J]. Liver Transpl, 2004; 10(5)621.
18. Olthoff KM, Brown RS Jr, Delmonico FL, et al. Summary report of a national conference: Evolving concepts in liver allocation in the MELD and PELD era. December 8, 2003, Washington, DC, USA [J]. Liver Transpl, 2004; 10(10 Suppl 2)A6.
19. Wang VS, Saab S. Liver transplantation in the era of model for endstage liver disease [J]. Liver Int, 2004; 24(1)1.
20. Trotter JF, Brimhall B, Arjal R, et al. Specific laboratory methodologies achieve higher model for endstage liver disease (MELD) scores for patients listed for liver transplantation [J]. Liver Transpl, 2004; 10(8)995.
21. McCaughan GW, Strasser SI. To MELD or not to MELD? [J]. Hepatology， 2001; 34(1)215.
22. Heuman DM, AbouAssi SG, Habib A, et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death [J]. Hepatology， 2004; 40(4)802.
23. Freeman RB. Mathematical models and behavior: assessing delta MELD for liver allocation [J]. Am J Transplant， 2004; 4(11)1735.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application and Significance of MELD Scoring System in Liver Transplantation

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