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The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease. It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. This score is now used by the United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score.〔 ==Determination== MELD uses the patient's values for serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. It is calculated according to the following formula:〔 :MELD = 3.78×ln(bilirubin (mg/dL) ) + 11.2×ln() + 9.57×ln(creatinine (mg/dL) ) + 6.43 UNOS has made the following modifications to the score: * If the patient has been dialyzed twice within the last 7 days, then the value for serum creatinine used should be 4.0 * Any value less than one is given a value of 1 (i.e. if bilirubin is 0.8, a value of 1.0 is used) to prevent the occurrence of scores below 0 (the natural logarithm of 1 is 0, and any positive value below 1 would yield a negative result) The etiology of liver disease was subsequently removed from the model because it posed difficulties such as how to categorize patients with multiple causes of liver disease. Modification of the MELD score by excluding etiology of liver disease did not significantly affect the model's accuracy in predicting three-month survival. Patients with a diagnosis of liver cancer will be assigned a MELD score based on how advanced the cancer is. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Model for End-Stage Liver Disease」の詳細全文を読む スポンサード リンク
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