This is done to ensure fairness and equity in the organ allocation system. If a transplant center were to skip patients at the top of the list it would have to provide a reason for that action to UNOS. The UNOS computer will provide the transplant center with a list of appropriate recipients based on blood types and MELD scores. When a liver becomes available in the patient's area, the computer will do a match run between the potential donor and potential recipients. All patients who are listed in the United States are placed in this national computer system. UNOS operates under contract from the federal government. It is a non-profit, charitable organization located in Richmond, VA.
The organization that manages the list is called UNOS (United Network for Organ Sharing). A patients transplant team keeps track of his MELD score and will notify him when he needs to have lab work done.Īnd speaking of the computerized transplant list. This guideline does not mean that your physician might not want lab tests performed more frequently rather, it is only what is required to stay active on the computerized transplant waiting list. People with high MELD scores may need weekly lab tests, while someone with a very low score might only be required to undergo lab tests every six to 12 months. Once a patient is on the transplant list he or she must have blood work done at scheduled intervals. Under the old system, it was possible for a relatively healthy person to receive a liver before someone who might not survive without a timely transplant, simply because he or she had spent more time on the waiting list.īecause the MELD score is based on lab work, it can vary each time a patient has lab work done. That system was disadvantageous for people with chronic liver disease who became seriously ill quickly. The old scoring system used the length of time a patient had spent on the waiting list, as well as a few subjective measures, to rank patients. This is done to assure that the sickest patients get the transplant first. The patient with the highest MELD score will get the liver when a donor is found. The purpose of the MELD scoring system is to use an objective measure to access how soon a person will need a liver transplant. A person with a MELD score of 40 might very well be quite ill and in a hospital intensive care unit. The scores range from 6 in a healthy person to 40. And the creatinine measures kidney function, which can be affected by advanced liver disease. The INR measures the liver's ability to manufacture certain clotting facots. The bilirubin number indicates how well your liver is excreting bile. These three tests are bilirubin, INR and creatinine. Your MELD score is calculated by taking three lab tests, plugging them into the formula and coming up with a number. MELD is a complex mathematical formula used to prioritize patients waiting for liver transplants. It is a relatively new term, and stands for Model for End Stage Liver Disease. What's your MELD Score? If you have liver disease you may have heard the term MELD bandied about by your physician or other members of your healthcare team. Mathematical system used to rank patients awaiting transplants
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