UNOS Listing Criteria: (as of 2/27/2002)
Status 1: Patient in ICU with life expectancy of <7 days, with Acute Liver Failure
Or 18yrs and Chronic Liver Failure.
MELD/PELD score (Model for End Stage Liver Disease ) Characterizes patients on an objective scoring system to determine medical need for transplantation bases on current Total Bilirubin, Pt INR and creatinine. Patients are given a score of 6 to 40 bases on severity of illness.
The score the patients receive determines the timing of the recertification.
|
Score |
Recertification |
Lab Values |
|
>25 |
Every 7 days |
<48 hours old |
|
24-19 |
Every 30 days |
<7 days old |
|
18-11 |
Every90 days |
<14 days old |
|
<10 |
Every year |
< 30 days old |
MELD Score Exceptions: Must be approved by the regional review board.
|
Disease/condition |
MELD Points |
Comment |
|
PSC |
The greater of either the calculated MELD or 25 points |
|
|
Intubated in ICU |
Calculated MELD plus 6 points |
No pneumonia, RDS etc |
|
TIPS failure |
Calculated MELD plus 6 |
By NYCLT definition |
|
Albumin <2.5 and NA <130 |
Calculated MELD plus 6 points |
|
|
Hepatopulmonary Syndrome |
Calculated MELD plus 8 points |
|
|
Hyperoxaluria |
Needs to be submitted and considered case by case |
|
|
Familial Amyloidotic Polyneuropathy (FAP) |
Needs to be submitted and considered case by case |
|
Points 1 2 3
Encephalopathy None 1-2 3-4
Ascites Absent Slight At least
(or controlled by diuretics) moderate despite diuretic treatment
Bilirubin (mg/dl) <2 2-3 >3
Albumin (g/dl) >3.5 2.8-3.5 <2.8
Prothrombin time
(seconds prolonged) <4 4-6 >6
or (INR) <1.7 1.7-2.3 >2.3
For primary biliary cirrhosis, primary sclerosing cholangitis or other cholestatic liver diseases:
Bilirubin (mg/dl)* <4 4-10 >10