The MELD score accurately predicts short-term mortality on the liver transplant waiting list. Thus, the Model for End-stage Liver Disease (MELD) score was developed as a simple, and more objective hepatic score compared to Child-Pugh score ( Table 1) ( 1- 3). However, the Child-Pugh score has the limitations of the subjective interpretation of ascites and encephalopathy. This score is based on five variables: ascites, encephalopathy, serum bilirubin, serum albumin and prothrombin time, which was empirically selected, and has been proved to be a reliable prognostic tool in many clinical situations ( 1, 2). Conclusion: despite some concerns, MELD score is currently useful for guiding liver transplant allocation.įor many decades the Child-Pugh score has been the main prognostic tool for cirrhotic patients. The MELD score has been widely validated in different populations of cirrhotic patients, but it has been suggested that creatinine weighs too heavily on this score. Recently, MELD alternative forms (sodium MELD, and corrected creatinine MELD), and its combination with estimated glomerular filtration rate (eGFR), have been proposed as more reliable markers. It accurately predicts short-term mortality on the liver transplant waiting list, and its three variables: serum bilirubin, creatininemia, and international normalized ratio, highlight the prognostic significance of the interactions between liver and renal functional variables in cirrhotic patients. The Model for End-stage Liver Disease (MELD) score was developed as a simple, and more objective hepatic score compared to Child-Pugh. Received: 11 October 2017 Accepted: 27 October 2017 Published: 18 November 2017. Acute kidney injury in cirrhosis: baseline serum creatinine predicts patient outcomes. Email: on: Wong F, O‘Leary JG, Reddy KR, et al. Human Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Argentina. Correspondence to: Carlos Guido Musso, MD, PhD.
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