医学
肝病
肝移植
经颈静脉肝内门体分流术
肌酐
内科学
门体分流术
终末期肝病模型
列线图
慢性肝病
门脉高压
胃肠病学
肝病学
肝硬化
移植
重症监护医学
外科
作者
Nikhilesh Mazumder,Robert J. Fontana
出处
期刊:Annual Review of Medicine
[Annual Reviews]
日期:2023-09-26
卷期号:75 (1)
标识
DOI:10.1146/annurev-med-051322-122539
摘要
The MELD (model for end-stage liver disease) 3.0 score was developed to replace the MELD-Sodium 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 cre (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. Expected final online publication date for the Annual Review of Medicine, Volume 75 is January 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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