Featured Research

from universities, journals, and other organizations

Model For Predicting Survival In Liver Patients Has Many Applications But Could Be Refined Further

Date:
March 2, 2007
Source:
John Wiley & Sons, Inc.
Summary:
A review of the studies on the Model for End-Stage Liver Disease (MELD) found that it is an accurate predictor of survival of patients with a variety of liver diseases, is particularly useful in allocating organs for liver transplants, and can also be used to help determine the course of treatment in certain cases. However, it is possible to improve the accuracy of the model and efforts at refining will continue.

A review of the studies on the Model for End-Stage Liver Disease (MELD) found that it is an accurate predictor of survival of patients with a variety of liver diseases, is particularly useful in allocating organs for liver transplants, and can also be used to help determine the course of treatment in certain cases. However, it is possible to improve the accuracy of the model and efforts at refining will continue.

This review appears in the March 2007 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD), published by John Wiley & Sons, Inc.

MELD uses three widely available laboratory tests in a mathematical formula to arrive at a score that predicts survival for patients with liver disease. It was initially created by researchers at the Mayo Clinic in Rochester, MN to predict survival following TIPS, a procedure to treat complications of liver disease that involves the placement of a shunt, but its use has been expanded. Most notably, for the past five years, MELD has become the standard for prioritizing patients awaiting liver transplants, replacing the previous system where patients who were on the list for the longest period of time received transplants first, regardless of how ill they were.

In the current review, Patrick S. Kamath, M.D. and W. Ray Kim, M.D. of the Mayo Clinic who were instrumental in creating and validating the model, reviewed how MELD is applied and assessed its strengths and limitations. They found that using MELD for organ allocation in liver transplants led to an immediate reduction in the number of patients awaiting a liver transplant (12 percent decrease in 2002) and also led to a reduction in mortality on the waiting list of almost 15 percent. However, MELD has not been shown to be useful in predicting mortality following a liver transplant, probably because other factors besides liver dysfunction play a role in transplant success. In addition, they found that use of healthcare resources has not increased since the implementation of MELD because the sickest patients, who were previously a drain on the healthcare system, are being transplanted earlier.

MELD, along with the traditional Child Turcotte Pugh (CTP) scoring system, predicts long-term survival in patients with late-stage cirrhosis, but MELD has other applications as well. In single center studies, it accurately predicts survival in patients with variceal (esophageal) bleeding and hepatitis B, and predicts mortality in patients with alcoholic hepatitis and infections leading to kidney failure. In addition, MELD can shed light on outcomes for liver cancer treatments and different types of surgery other than liver transplants.

Despite its accuracy, MELD has some limitations. For patients awaiting liver transplants, it should be used only after reversible complications, such as bacterial infections, have been treated. Also, the values used to determine the MELD score may be variable depending on how they are measured. In order to refine MELD, the authors conducted a study on how changing MELD scores affect mortality. They found that the current MELD score was the most important predictor of survivor, regardless of how it was reached.

"In conclusion, based on its ability to rank patients with cirrhosis according to their short term mortality, MELD has been recognized as a major contributor to the daily practice of hepatology," the authors state. "Successful implementation of MELD-based liver allocation in the U.S. has been followed by widespread adoption of the system globally, attesting to its validity." It is also a useful tool in a wide spectrum of disease severity and variety. However, since it is by no means a perfect system, the authors conclude, efforts to refine it must continue.

Article: "The Model for End-Stage Liver Disease (MELD)," Patrick S. Kamath, W. Ray Kim, Hepatology; March 2007 (DOI: 10.1002/hep.21563).


Story Source:

The above story is based on materials provided by John Wiley & Sons, Inc.. Note: Materials may be edited for content and length.


Cite This Page:

John Wiley & Sons, Inc.. "Model For Predicting Survival In Liver Patients Has Many Applications But Could Be Refined Further." ScienceDaily. ScienceDaily, 2 March 2007. <www.sciencedaily.com/releases/2007/03/070301102522.htm>.
John Wiley & Sons, Inc.. (2007, March 2). Model For Predicting Survival In Liver Patients Has Many Applications But Could Be Refined Further. ScienceDaily. Retrieved April 24, 2014 from www.sciencedaily.com/releases/2007/03/070301102522.htm
John Wiley & Sons, Inc.. "Model For Predicting Survival In Liver Patients Has Many Applications But Could Be Refined Further." ScienceDaily. www.sciencedaily.com/releases/2007/03/070301102522.htm (accessed April 24, 2014).

Share This



More Health & Medicine News

Thursday, April 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Big Pharma Braces for M&A Wave

Big Pharma Braces for M&A Wave

Reuters - Business Video Online (Apr. 22, 2014) Big pharma on the move as Novartis boss, Joe Jimenez, tells Reuters about plans to transform his company via an asset exchange with GSK, and Astra Zeneca shares surge on speculation that Pfizer is looking for a takeover. Joanna Partridge reports. Video provided by Reuters
Powered by NewsLook.com
Study Says Most Crime Not Linked To Mental Illness

Study Says Most Crime Not Linked To Mental Illness

Newsy (Apr. 22, 2014) A new study finds most crimes committed by people with mental illness are not caused by symptoms of their illness or disorder. Video provided by Newsy
Powered by NewsLook.com
Hagel Gets Preview of New High-Tech Projects

Hagel Gets Preview of New High-Tech Projects

AP (Apr. 22, 2014) Defense Secretary Chuck Hagel is given hands-on demonstrations Tuesday of some of the newest research from DARPA _ the military's Defense Advanced Research Projects Agency program. (April 22) Video provided by AP
Powered by NewsLook.com
How Smaller Plates And Cutlery Could Make You Feel Fuller

How Smaller Plates And Cutlery Could Make You Feel Fuller

Newsy (Apr. 22, 2014) NBC's "Today" conducted an experiment to see if changing the size of plates and utensils affects the amount individuals eat. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins