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11/05/2010 12:22 PM

Latest MELD

mikealpha1
mikealpha1  
Posts: 2286
Group Leader

Blood test and MELD score 10/28 = 16. This year it's been 14 in July, 15 in May, 19 in April and 14 in January. Just goes to show it's not necessarily a steady climb.
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11/05/2010 12:46 PM
mpmom
mpmom  
Posts: 3275
VIP Member
I'm an Advocate

Not always MIke.

Most people I know go up and down (it seems like when the wind blows)

Gail


11/05/2010 12:47 PM
Capedrifter
Posts: 323
Member

Mike, can you explain the MELD score a little bit? What is a desired score? If the numbers did move up only a point at a time quarter by quarter, what would that imply? What drives the score or what can one do or not do to affect the score? Could it move in multiple points one way of another, for example, a swing of 6 or 10 points?

11/05/2010 01:36 PM
dmanflan
dmanflan  
Posts: 1734
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I'm an Advocate

Hey Capedrifter!

We had a discussion on MELD a little while before you joined us. See MELD Scores for a lively discussion.

I hope all is well for you and your wife!

Dennis

Post edited by: dmanflan, at: 11/05/2010 01:36 PM


11/05/2010 01:50 PM
Capedrifter
Posts: 323
Member

Hi Dennis, I was online for that discussion and I found it most instructive. MELD is not something I'd paid attention to and I was pleased to read your thorough report on MELD (as well as other valuable posts from you - thanks so much). However, my question was about the meaning of a single or two point move, up or down, or a wider swing and what that would imply. After re-reading your MELD post, I assume it means very little and is not a definitive marker of this illness; but, rather another speck of data that has to me considered with numerous other data inputs, mostly from blood draws - phew!. EDIT Ok, I think I got it. At the bottom of the page-view, bj had a link to a MELD calculator site and I think that cleared up whatever confusion I was feeling about the application of MELD.

Post edited by: Capedrifter, at: 11/05/2010 02:01 PM


11/05/2010 02:14 PM
dmanflan
dmanflan  
Posts: 1734
Group Leader
I'm an Advocate

Yep!

I think the only time that MELD score is any value to the patient is when it jumps 3 or more points AND holds at that level across multiple lab tests. Chances are your hepatologist will already know the results and have taken some action so even this situation should not be overly concerning. One other time to take notice of MELD score is when it is approaching the mid 20s or whatever level is common for transplantation in your area. At this point it really only means to have your bag packed to be ready to get to the tx center on time! (BTW you don't really need to bring anything to the hospital when summoned, you won't need anything until a couple of days later.)

Geeez! I turned a three letter response into a doctoral dissertation--sorry!Blush

Dennis


11/05/2010 05:59 PM
fredsmith3
fredsmith3  
Posts: 37
Member

I have a question. Here in L.A., for type A Blood, the average meld score for transplant is in the 30's (so I'm told from our transplant RN).

I am just wondering what the average meld score is for other cities across the country. Can some of you guys let me know (if you know).

Dennis - do you know how much variance there is from city to city.

And, I'm not getting hung up on meld scores. Just curious.Smile


11/05/2010 08:12 PM
dmanflan
dmanflan  
Posts: 1734
Group Leader
I'm an Advocate

Hi Susie!

The average meld scores can vary quite a lot by different parts of the country. Mathematically, 40 is the highest meld possible and generally indicates the patient is hours away from passing, thus the highest priority. I suspect if the average is that high, there is either a lot of people needing organs, a lack of suitable donor organs or both. You can be listed in two different centers as long as all the tests are satisfied at both centers and you are able to get to the tx center in the allotted time.

Hope this helps!

Dennis


11/05/2010 09:38 PM
bjlvls
bjlvls  
Posts: 1013
Senior Member

Susie,

I have a bit of information from the California Pacific Medical Center that may help explain the situation in your OPTN region, Region 5.

What is the average MELD score for a patient undergoing transplant?

Currently, the average MELD score for a patient undergoing a liver transplant is 20 nationally. The average MELD score for liver transplant patients in our region varies from 26-33, depending on blood type.

The average waiting time for a patient to receive a liver in our region, once a patient is placed on the UNOS waiting list, is 12-36 months. This waiting time may be very short for a patient with very high MELD scores and especially those with acute liver failure.

Waiting time varies according to blood type, e.g. patients with O blood type wait longer on average, and patients with B, A & AB blood type wait a shorter period of time. The severity of a patient's liver disease and any contributing medical illnesses, such as kidney failure and/or liver cancer, may result in a patient receiving a higher MELD score. As a patient's MELD score increases, the priority to receive a liver transplant increases. If a patient's condition improves, and the MELD score decreases, the priority to receive a liver transplant decreases.

Transplant physicians, nurses and social workers cannot accurately predict when a donor liver will become available for an individual patient. The availability of donors is too variable and the lists at the local transplant centers can fluctuate every day.

The states comprising each region throughout the U.S. are as follows:

Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Eastern Vermont

Region 2: Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, West Virginia, Northern Virginia

Region 3: Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Puerto Rico

Region 4: Oklahoma, Texas

Region 5: Arizona, California, Nevada, New Mexico, Utah

Region 6: Alaska, Hawaii, Idaho, Montana, Oregon, Washington

Region 7: Illinois, Minnesota, North Dakota, South Dakota, Wisconsin

Region 8: Colorado, Iowa, Kansas, Missouri, Nebraska, Wyoming

Region 9: New York, Western Vermont

Region 10: Indiana, Michigan, Ohio

Region 11: Kentucky, North Carolina, South Carolina, Tennessee, Virginia

As Dennis stated, the average Meld score at transplant from one region to another can vary greatly. It's tough to put accurate information together, because regions and centers across the nation may list at different scores, so the stats are skewed. I can tell you that right now, regions 3,6,10, and 11 have the lowest average transplant MELD (from 20-25). Regions 1 and 5 currently transplant at the highest.You can go to the OPTN site for more national info:

http://optn.transplant.hrsa.gov/members/regions.asp

The drop down menus on this site have tremendous amounts of information. The Data, and Donation and Transplantation menus are incredible research tools.

You can be listed at multiple sites, but having the means to meet the stringent travel and time requirements necessary to comply with each site's rules is a real challenge for most of us. The evaluation process alone is pretty cumbersome.

I hope this helps more than it confuses you. It's a lot to take in!

Bobbi

Post edited by: bjlvls, at: 11/06/2010 08:12 AM


11/06/2010 07:44 AM
mikealpha1
mikealpha1  
Posts: 2286
Group Leader

Well, Capedrifter, I think your question has been answered pretty well. Mpmom, not always what? I was just pointing out, for those that weren't aware, that MELD does go up and down day to day.
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