June 11, 2012

What is a MELD score?

Bloodwork for the Liver Clinic
If you have been following for a while you have heard me talk a bit about my MELD score.  And a lot of people ask " what is a MELD score?"  So I figured I will explain what it is, how its found and how if plays in to my life of the transplant list.

MELD scores from 6 - 40 and are used to measure the urgency of a transplant.  So the higher the number the closer you are to transplant.  The score is calculated by taking a look at three test results.  Bilirubin, Creatinine and INR.

Bilirubin is yellow pigment found in bile that is made by our livers and stored in our gall bladders.  As you liver fails the bilirubin is not properly disposed of and that is when jaundice sets in.  Causing the yellowing of the skin and eyes. A normal bilirubin level is usually less that 1mg/dL.  Last time I had it checked mine was a 1.4

Creatinine is chemical that is the kidney usually filters out of our blood.  If the kidney is not working properly, creatinine will build up in your blood. By testing the amount the doctors are able to measure how well, or not, our kidneys are functioning. Just like the bilirubin, creatinine is usually less that 1mg/dL.  My last labs show me at 0.72. No complaints there.

INR is the third.  This measures our livers ability to make blood clotting factors.  A higher number means that the liver is taking more time to coagulate or form blood clots.  In my case, because of my blood disorder, I am on blood thinners.  My INR is monitored not only by my transplant team but a hematologist as well.  It is also kept a little higher because I am prone to clot. The average range is 0.8 -1.2.  I am kept at 2-3.

All together, these 3 tests decide what my score is and define my place on the transplant list.  I have varied from 9-22.  Mostly because of my blood thinners.  Either way, I am not high enough on the list to be expecting a call any time soon.  Nor do I have any other complications that would  bump me up any.  So we wait.  Hopefully this helps some of you better understand what I'm talking about.  Hopefully I have explained it all properly.  I should take note from my liver buddy Ricki and give a general disclaimer to my hepatic encephalopathy! It makes my brain mushy!!

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