[The value of MELD in the allocation of priority for liver transplantation candidates].
Liver transplantation is the most effective treatment for many patients with chronic end-stage liver disease. The discrepancy between the number of donor organs and potential recipients causes marked pre-transplantation mortality and consequently optimal rationalization of organ allocation is essential. The Model for End-Stage Liver Disease (MELD) is an objective and easily reproducible prognostic index of mortality based on three simple analytical variables: bilirubin and serum creatinine and the prothrombin time/International Normalized Ratio (INR) of protrombine time. The implementation of MELD as an organ allocation system has reduced mortality on the waiting list without affecting post-transplantation survival. Nevertheless, this model has some limitations and consequently further investigations should be performed to improve the organ allocation policy in liver transplantation.
Colmenero
Jordi
J
Unitat de Trasplantament Hepàtic, Servei d'Hepatologia, Institut Clínic de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, España. jcolme@clinic.ub.es
Castro-Narro
Graciela
G
Navasa
Miguel
M
D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D003404:Creatinine / Q000097:blood; D020065:Hepatopulmonary Syndrome / Q000503:physiopathology; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D019934:International Normalized Ratio; D017093:Liver Failure / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D008661:Metabolism, Inborn Errors / Q000150:complications; D008954:Models, Biological; D018579:Patient Selection; D011184:Postoperative Period; D011379:Prognosis; D012720:Severity of Illness Index; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement; D014850:Waiting Lists
D003404:Creatinine; D001663:Bilirubin