MELD 3.0: A better score for liver allocation?

Singh, Satender Pal; Maiwall, Rakhi

doi:10.1097/lvt.0000000000000180

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…Interestingly, the recently developed MELD 3.0 was reported to better predict waitlist mortality by incorporating serum creatinine, serum albumin and female sex 27 . However, the effect of MELD 3.0 on the organ allocation rate for the ever-growing population of MASLD patients remains to be seen 1 , 28 .…”

Section: Discussionmentioning

confidence: 99%

MELD-Na score may underestimate disease severity and risk of death in patients with metabolic dysfunction-associated steatotic liver disease (MASLD)

Yardeni,

Shiloh,

Lipnizkiy

et al. 2023

Sci Rep

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Portal hypertension often precedes the development of advanced fibrosis in patients with Metabolic dysfunction-associated steatotic liver disease (MASLD) and may accelerate disease progression to cirrhosis. We aimed to evaluate whether prioritization tools accurately predict survival in patients with MASLD and clinically significant portal hypertension (CSPH). We retrospectively identified patients diagnosed with esophageal or gastric varices (EGV). Laboratory results, endoscopy reports and outcomes of patients with MASLD were compared to patients with advanced stage chronic liver disease (CLD) of other etiologies. During the study period 326 patients were diagnosed with EGV. 88 (26.9%) had MASLD, 113 (34.6%) viral hepatitis (VH), 63 (19.3%) alcoholic liver disease (ALD) and 62 (19%) both VH and ALD (VHALD). EGV bleeding events were significantly more frequent in patients with MASLD (36.3%), compared to VH (28.3%), ALD (30.1%) and VHALD (25.8%), respectively (p < 0.01). Mean Model for End-Stage Liver Disease (MELD)-Na score surrounding 1 year of first event of EGV bleeding was significantly lower in MASLD patients compared to all other etiologies (p = 0.02). At a MELD-Na score of 11–20, cumulative survival rate was significantly lower in MASLD patients compared to all other etiologies (log rank p < 0.01). MASLD patients present with EGV bleeding at lower MELD-Na scores compared to other etiologies of CLD. MELD-Na score may therefore underestimate disease severity and risk of death in patients with MASLD and CSPH.

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Section: Discussionmentioning

confidence: 99%