Table 1 History and development of liver allocation
Name | Contributing Author(s) | Year of Publication | Year of Adoption by UNOS | Objective | Included Criteria | Changes to Criteria | Range of Scores | Calculation |
|---|---|---|---|---|---|---|---|---|
Before CTP | N/A | N/A | N/A | Predict death without transplant Identify highest severity | Severity of liver disease, time accrued on the waitlist | N/A | N/A | Severity of disease was reflected by the level of care received: hospitalized (ICU), hospitalized (general), outpatient care |
Child–Pugh–Turcotte (CTP) score | Pugh et al. | 1973 | 1996 | Prioritize sicker patients for liver transplantation | Serum albumin, serum bilirubin, prothrombin time, ascites, encephalopathy | + Serum Albumin + Serum Bilirubin + INR + Ascites + Encephalopathy - Time accrued on waitlist - Treatment and hospitalization status | 5 to 15 | Each variable was scored from 1 to 3 and was given equal weight. Individual scores were added together for a final CTP score |
Transjugular intrahepatic portosystemic shunt (TIPS) Model | Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864–871. | 2000 |  N/A | Predict three-month mortality in cirrhotic patients undergoing TIPS | Serum creatinine, serum bilirubin, INR, etiology of cirrhosis | + Serum Creatinine + etiology of cirrhosis - Ascites - Encephalopathy |  | TIPS risk score = 0.957 x ln(creatinine mg/dL) + 0.378 x ln(bilirubin mg/dL) + 1.120 x ln(INR) + 0.643 x (cause of cirrhosis). |
MELD | Kamath et al. | 2001 | 2002 | Predict survival | Serum bilirubin, creatinine, INR | + Creatinine - Albumin - Ascites - Encephalopathy | 6 to 40 | MELD = 9.57 x ln (creatinine) + 3.78 x ln (total bilirubin) + 11.2 x ln (INR) + 6.43 |
MELD-Na | Kim et al. | 2008 | 2014 | Predict survival | Serum bilirubin, creatinine, INR, sodium | + Sodium | 6 to 40 | MELD-Na = MELD + [1.32 × (137 - Na) - [0.033 x MELD x (137 - Na)] |
MELD 3.0 | Kim et al. | 2021 | 2023 | Predict survival | Serum bilirubin, albumin, creatinine, INR, sodium, sex | + Albumin + Sex | 6 to 40 | MELD 3.0 = 1.33 (if female) + [4.56 x In (bilirubin)] + [0.82 × (137 - Na)] - [0.24 × (137 - Na) x In (bilirubin)] + [9.09 x In (INR)] + [11.14 x In (creatinine)] + [1.85 × (3.5 - albumin)] - [1.83 × (3.5 - albumin) x ln (creatinine)] + 6 |