MELD score

[Sammi56]

can someone please explain the MELD score? My son has just been discharged from hospital following a HE event and on his discharge letter it says MELD 29. He’s been in hospital several times but this has never been on his discharge letter before

[AyrshireK]

From the British Liver Trust website

"MELD stands for Model for End-stage Liver Disease. It uses a calculation based on your blood levels of:

creatinine

bilirubin

INR

There are some versions of the MELD score that also add in other things. Including:

the amount of sodium in your blood

if you are male or female

albumin

age

The calculation gives a MELD score of between 6 and 40.

The more severe your cirrhosis is, the higher your MELD score will be. Your doctor can talk you through your MELD score and how they calculated it.

In some other countries, including the USA, MELD scores are used to make decisions about transplants."

In the UK they would generally use UKELD (United Kingdom Model for End Stage Liver Disease) where a score of 49+ used to be the minimum required for transplant listing. As they have already discussed potential transplant with your son this new score may help decide whether progress to assessement is now required.

HE is awful, I know 'cos I lived with my hubby suffering with it severely for the best part of 6 months (and milder version before that). Hubby was transplanted last June and the HE went almost immediately.

Best wishes,

Katie

[Sammi56 in reply to AyrshireK]

Thank you so much for your reply. This HE episode was really bad. In hospital for 9 days. He’s also diabetic which doesn’t help.

[AyrshireK in reply to Sammi56]

My husband developed diabetes due to his cirrhosis - post transplant he's on insulin and doing ok with it. Hubby had a stay in hospital with acute HE before his transplant assessment - it was awful. We went through an ordeal with it up to his transplant - I was nursing him 24/7 as he became totally dependent.

I hope your son gets his assessment soon (i'd be pushing for it) if things keep going downhill like this.

Katie

[Sammi56 in reply to AyrshireK]

Thank you. It’s such a worrying time. Good luck x

[Fibro2021 in reply to Sammi56]

I would like to add to Katie's reply that in cases of persistent severe hepatic encephalopathy (HE) or the development of complications like hepatopulmonary syndrome, the decision for a liver transplant may be made even if the MELD score is not very high. These conditions can significantly affect the patient's quality of life and pose a life-threatening risk, making a transplant necessary, despite a lower MELD score. Doctors typically assess the patient comprehensively, considering not only MELD score results but also the patient's clinical condition, especially if symptoms like severe HE are progressing or not responding to treatment. Therefore, even with moderate MELD scores, a liver transplant might become essential.

Hope this helps clarify the situation for your son and provides additional guidance when making treatment decisions.