Table 1.
Liver Allocation Models
| Allocation Models | Formula1 | Details |
|---|---|---|
| MELD (1, 2) | 9.57 Loge Cr + 3.78 LogeBil + 11.2 LogeINR +6.43 | Values of Cr greater than 4.0 are set to 4.0. Values of Cr, Bil or INR below 1.0 are set to 1.0. Those on dialysis are given a Cr of 4.0. The score is rounded to the nearest integer and capped at 40. |
| MESO Index (5) | MELD/Na (mEq/l) × 10 | MELD is calculated as above, but it is not rounded or capped at 40. |
| MELDNa (6) | MELD − Na −[0.025(MELD)(140-Na)] + 140 | MELD is calculated as in the original formula (rounded, capped at 40). Values of Na below 125 are set to 125 and values of Na above 140 are set to 140. After calculation, the score is rounded to the nearest integer. |
| Updated MELD (7) | 1.266 Loge(Cr+1) + 0.939 Loge(Bil+1) + 1.658 Loge(INR+1) | Values of Cr, Bil and INR are not changed, irrespective of their values, or whether the patient is on dialysis. |
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| ||
| UKELD (8) | 1.485 Loge (Cr) + 3.13 Loge(Bil) + 5.395 Loge(INR) −81.565 Loge(Na) + 435 | Values of Cr (μmol/l) greater than 400 are set to 400. Values of Cr, Bil or INR below 1.0 are set to 1.0. Na is truncated to be between 112 and 150. The score is rounded to the nearest integer. For those on dialysis, Cr is given the value found when the patients were not on dialysis2. |
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| ||
| ReFit MELD (9) | 8.485 Loge(Cr) + 4.082 Loge(Bil) + 10.671 Loge(INR) + 7.432 | Values of Cr greater than 3.0 are set to 3.0. Values of Cr below 0.8 are set to 0.8. Values of Bil or INR below 1.0 are set to 1.0. Values of INR above 3.0 are set to 3.0. Those on dialysis are given a Cr of 3.0. The score is rounded to the nearest integer. |
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| ||
| ReFit MELD NA (9) | 6.792 Loge(Cr) + 4.258 Loge(Bil) + 8.29 Loge(INR) + 0.652(140-Na) − 0.194(140-Na)Loge(BiliCC) | Values of Cr, Bil, and INR are defined as for ReFit MELD. Values of sodium below 125 are set to 125 and values of sodium above 140 are set to 140. BiliCC is the same as Bil, however, values over 20 are set to 20. The score is rounded to the nearest integer. |
1
In all the formulae except UKELD, Cr refers to serum creatinine (mg/dl), Bil to total bilirubin (mg/dl), INR to prothrombin time-international normalized ratio, and Na to serum sodium (mmol/l). For UKELD, Cr refers to serum creatinine (μmol/L), Bil to total bilirubin (μmol/L),.
2
Since we did not know the patient’s non-dialysis creatinine value, those on dialysis were given the maximum value of Cr (400 μmol/L).