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Annual Review of Medicine

Volume 75, 2024

MELD 3.0 in Advanced Chronic Liver Disease

Abstract

The MELD (model for end-stage liver disease) 3.0 score was developed to replace the MELD-Na score that is currently used to prioritize liver allocation for cirrhotic patients awaiting liver transplantation in the United States. The MELD 3.0 calculator includes new inputs from patient sex and serum albumin levels and has new weights for serum sodium, bilirubin, international normalized ratio, and creatinine levels. It is expected that use of MELD 3.0 scores will reduce overall waitlist mortality modestly and improve access for female liver transplant candidates. The utility of MELD 3.0 and PELD (pediatric end-stage liver disease, creatinine) scores for risk stratification in cirrhotic patients undergoing major abdominal surgery, placement of a transjugular intrahepatic portosystemic shunt, and other interventions requires further study. This article reviews the background of the MELD score and the rationale to create MELD 3.0 as well as potential implications of using this newer risk stratification tool in clinical practice.

Keyword(s): decompensated cirrhosis, liver transplantation, model for end-stage liver disease, organ allocation, prognostic score
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/content/journals/10.1146/annurev-med-051322-122539
2024-01-29
2024-04-30
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/content/journals/10.1146/annurev-med-051322-122539
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MELD 3.0 in Advanced Chronic Liver Disease
Annual Review of Medicine 75, 233 (2024); https://doi.org/10.1146/annurev-med-051322-122539
/content/journals/10.1146/annurev-med-051322-122539
/content/journals/10.1146/annurev-med-051322-122539
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