After going through an evaluation process that includes a wide range of tests and procedures you will meet with a liver transplant team to discuss your condition and put on a liver transplant waiting list. This list is maintained by the UNOS (United Network for Organ Sharing).
Determining who gets a liver is based on a formula that takes into consideration lab values such as, creatinine, total bilirubin, and INR. UNOS will then assign a MELD score based upon these values.
The higher the MELD score the sicker the patient, and the higher on the transplant waiting list. UT Southwest Medicine reports livers are only matched for blood type (A, B, O, AB) and size. Unlike other organs, special tissue typing is not necessary to determine which liver donor makes the best match.
The MELD score assigned to each liver transplant patient is re-assessed and re-certified. MELD scores range from 0-40 or greater. On the waiting list, all liver patients and their MELD scores are reassessed and re-certified on a frequent basis.
In this video, Dr. Joe Galati, a Liver Specialist in Houston, discusses how the MELD score is calculated, and how MELD exception points are calculated. Dr. Galati is affiliated with Liver Specialists of Texas and the Center for Liver Disease and Transplantation at The Methodist Hospital in Houston, Texas, a leading liver transplant center in the United States. The Methodist Hospital is the largest liver transplant center in Texas, and one of the largest in the United States.
The MELD score is calculated by determining the patients bilirubin, creatinine, and INR. The MELD score ranges from 5-40. The higher the MELD score, the more advanced the liver disease is, and the sooner the patient will be allocated a liver for transplant.
Very helpful articles and videos to understand more about liver transplants and the steps for evaluation include:
- John Hopkins Medicine
- The Washington University and Barnes -Jewish Hospital Liver Transplant Program
- University of California San Francisco Medical Center: Liver Transplant Program
- Liver Specialist of Texas/Dr. Joseph Galati M.D.
- Methodist J.C. Walter Transplant Center
- UT Southwest Medical
- Information on Living Donor Transplants from UNOS
- American Liver Foundation