Recently, various modifications of the MELD have been introduced and improved accuracy in both, chronic liver failure and ALF [ 12, 13].
As hyponatremia is a common clinical problem in patients with end stage liver disease, especially in those individuals with portal hypertension, ascites and hepatorenal syndrome, sodium based modifications of the MELD have been introduced.
14 Alongside these disease-specific formulas, previous studies (including 34, 15 73 16 and 202 17 patients) have outlined the utility of the model for end-stage liver disease (MELD) for predicting mortality in AH, whereas the utility of the MELD including sodium (MELD-Na) has been also assessed in a small study.
The MELD score has been implied as a prognostic tool in ALF.
98 103 The MELD score has been shown to outperform Child's score in a recent study, with a score >19 associated with 20% 6 week mortality.
103 Furthermore, the MELD score has been shown to perform as well as the traditional intensive care unit scores in predicting mortality in patients admitted to intensive care in the UK.
The CPT, MELD, and MELD-Na score has been validated as independent predictors of survival in candidates for liver transplantation.
36 The MELD-CAP score has been show to outperform CURB-65 and PSI in patients with cirrhosis.
The MELD scoring system has been implemented in United States for prioritization in 2002, and within the alliance of Eurotransplant November 2006.
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