Advancements in MELD Score and Its Impact on Hepatology

David Hudson; Francisco Javier Valentin Cortez; Ivonne Hurtado Díaz de León; Gurpreet Malhi; Angelica Rivas; Tamoor Afzaal; Mahsa Rahmany Rad; Luis Antonio Diaz; Mohammad Qasim Khan; Juan Pablo Arab

doi:10.1055/a-2464-9543

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2025; 45(02): 236-251
DOI: 10.1055/a-2464-9543

Review Article

Advancements in MELD Score and Its Impact on Hepatology

Authors

David Hudson

¹Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada
Francisco Javier Valentin Cortez

²Obesity and Digestive Diseases Unit, Medica Sur Hospital, Mexico City, Mexico
Ivonne Hurtado Díaz de León

³Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Gurpreet Malhi

¹Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada
Angelica Rivas

⁴Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Tamoor Afzaal

¹Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada
Mahsa Rahmany Rad

¹Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada
Luis Antonio Diaz

⁵Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

⁶Division of Gastroenterology and Hepatology, MASLD Research Center, University of California San Diego, San Diego, California
Mohammad Qasim Khan

¹Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada

⁷Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
Juan Pablo Arab

⁵Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

⁸Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia

Abstract

There continues to be an ongoing need for fair and equitable organ allocation. The Model for End-Stage Liver Disease (MELD) score has evolved as a calculated framework to evaluate and allocate patients for liver transplantation objectively. The original MELD score has undergone multiple modifications as it is continuously scrutinized for its accuracy in objectively representing the clinical context of patients with liver disease. Several refinements and iterations of the score have been developed, including the widely accepted MELD-Na score. In addition, the most recent updated iteration, MELD 3.0, has been created. The MELD 3.0 calculator incorporates new variables such as patient sex and serum albumin levels and assigns new weights for serum sodium, bilirubin, international normalized ratio, and creatinine levels. It is anticipated that the use of MELD 3.0 scores will reduce overall waitlist mortality and enhance access for female liver transplant candidates. However, despite the emergence of the MELD score as one of the most objective measures for fair organ allocation, various countries and healthcare systems employ alternative methods for stratification and organ allocation. This review article will highlight the origins of the MELD score, its iterations, the current MELD 3.0, and future directions for managing liver transplantation organ allocation.

Keywords

cirrhosis - liver disease - model for end-stage liver disease - hepatology - risk stratification - organ allocation

Full Text

References

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