Wednesday, November 24, 2010

Q; The Model for End-Stage Liver Disease, or MELD, is a scoring system now used by the United Network for Organ sharing (UNOS) for prioritizing allocation of liver transplants. It takes in account all of the following EXCEPT?

A) Serum Bilirubin
B) Serum creatinine
C) INR
D) Stage of (hepatic) encephelopathy





Answer: D

MELD =
3.8 x log (e) (bilirubin mg/dL) + 11.2 x log (e) (INR) + 9.6 log (e) (creatinine mg/dL)

UNOS has made the following modifications to the score:

A) If the patient has been dialyzed twice within the last 7 days, then the value for serum creatinine used should be 4.0
B) Any value less than one is given a value of 1.


In interpreting the MELD Score in hospitalized patients, the 3 month mortality is:

40 or more — 71.3% mortality
30–39 — 52.6% mortality
20–29 — 19.6% mortality
10–19 — 6.0% mortality
less than 9 — 1.9% mortality