If you have a serious liver disease, your doctor may have talked to you about a 'MELD score.' Hearing this word may make you feel a little scared and worried. "What does this mean? Is my condition serious?" You may have many questions in your mind. Don't worry. Today, we'll talk about what this MELD score is and what it means in a very simple way that you can understand.
What does the MELD score simply mean?
Simply put, the MELD score is a score that measures how severe your liver disease is. This score is calculated on a scale of 6 to 40. The higher your MELD score, the more severe your liver disease is.
This scoring system is mainly used to help decide where you should be placed on the liver transplant waiting list. That is, it helps to understand who needs a liver most quickly.
MELD stands for 'Model for End-Stage Liver Disease'. It is a mathematical formula. It uses a number of factors, including your blood test results, age, and medical history, to create it. This MELD score is used for people over the age of 12. For children younger than that, doctors use a different method called PELD (Pediatric End-Stage Liver Disease).
How is this MELD score calculated?
Calculating the MELD score is a bit of a complicated process. It's based on the results of several key blood tests that your doctor will give you. Let's take a look at what they are.
| Blood test | Simply put, what does it measure? |
|---|---|
| INR (International Normalized Ratio) | This measures how long it takes for your blood to clot. A longer clotting time usually means that your liver is not working properly. |
| Total Bilirubin | This measures how well the bile produced by the liver is being excreted from the body. Elevated bilirubin levels indicate poor liver function. |
| Creatinine | This measures the function of your kidneys. You may wonder why kidneys are checked when you have liver disease. The reason is that when liver disease becomes severe, it can also affect kidney function. |
| Serum Sodium | The amount of sodium in your blood is measured. Low sodium levels can also be a sign of poor liver function. |
| Albumin | This is a type of protein made by the liver. It helps retain water in the blood. A low albumin level is also a sign of poor liver function. |
In addition to these blood tests, your doctor will consider several other factors.
- Your medical history, meaning what liver disease you have and how severe it is.
- Your age and gender at birth.
- Other illnesses you have, and whether they can cause complications.
- Your lifestyle and social factors (for example, things like drinking alcohol)
Extra points added on special occasions
Sometimes, your MELD score alone may not fully reflect the severity of your condition. In such cases, your doctor may request that additional points be added to your score. These are called 'exception points'.
The following are the situations in which you can usually get extra points:
- Acute liver failure
- Liver cancer
- Low blood oxygen levels due to liver disease (Hepatopulmonary syndrome)
- Increased blood pressure in the lungs due to liver disease (Portopulmonary hypertension)
- Polycystic liver disease, a rare genetic disease
- Chronic cholangitis
It is very important to ask your doctor to clearly explain what factors were used to calculate your MELD score.
Can the MELD score change?
Yes, definitely.The MELD score is not a fixed number. It can change depending on your condition. Your doctor will update your MELD score by repeating your blood tests at regular intervals .
How often you do this will depend on how quickly your condition is changing. Your score may increase if your condition is getting worse. Your score may also decrease if your condition is improving somewhat with treatment.
How do you understand what the MELD score says?
Doctors use the MELD score to get an idea of two main things.
1. What is the risk of dying within the next 90 days due to liver disease?
2. How soon you need a liver transplant.
Don't worry about this risk. This is just a general estimate based on statistics. It can vary from person to person.
| MELD Score | Risk of death within 90 days (average) |
|---|---|
| Under 9 | 1.9% |
| 10 - 19 | 6.0% |
| 20 - 29 | 19.6% |
| 30 - 39 | 52.6% |
| 40 or older | 71.3% |
The most important thing:No one can accurately predict your life expectancy from your MELD score. It only gives your doctor a general idea of your condition and helps them decide how soon you need a liver transplant.
How long it takes for you to receive a liver is not determined solely by your MELD score. It is influenced by many other factors, such as your blood type and whether there are liver donors in your area.
So, don't overthink your MELD score or draw wrong conclusions about your future. The best thing to do is to talk openly about it with your doctor. He or she will be able to explain your results to you and give you a clear idea of your situation and what to expect going forward.
Take-Home Message
- The MELD score is a scoring system that measures how severe your liver disease is. The higher the score, the more serious the condition may be.
- This score is calculated based on your blood tests (such as INR, bilirubin, creatinine) and several other factors.
- The MELD score is not fixed. It can change over time depending on your condition.
- This scoring system mainly helps you get priority on the liver transplant waiting list.
- Don't worry too much about your MELD score. It's just a tool to help you understand your condition. Talk openly with your doctor about any questions or concerns you may have.
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