What Is a Meld Test for Liver Transplant?

MELD, which stands for Model End-Stage Liver Disease, is a tool used to determine the degree of illness in patients waiting for liver transplant. The MELD scoring system, originally designed by the Mayo Clinic, has been modified by UNOS, the United Network for Organ Sharing.

Purpose

• The MELD score is used to ensure that the sickest patients get livers first. Three blood levels are taken; the MELD score formula coverts the three into a number that indicates how sick the patient is; the number is used to place the person on the waiting list. The higher the number, the sicker the patient. The tests evaluate blood clotting, kidney function and liver function; all three are affected by liver disease, according to the Mayo Clinic.

INR

• INR, which stands for International Normalized Ratio, compares the clotting time of a patient's blood to a standardized time. A person with an INR of 1 has blood that clots within the same time frame as a "normal" person. People with higher numbers have blood that clots more slowly.

Bilirubin

• Bilirubin is a byproduct of red blood cell production; bilirubin rises in cirrhosis because the damaged liver can't remove it from the blood.

Creatinine

• Creatinine is a byproduct of muscle breakdown; a rise in creatinine means that the kidneys aren't functioning well.

Dialysis

• The MELD formula asks if the patient has had dialysis in the past week because dialysis removes waste products from blood and affects the test results.