Re: More obstacles - More Questions - MELD

[Guest guest]

> Does a transplant center tell/give you any idea of what your MELD

score

> has to be before they would even consider doing a LDLT?

With a LDLT the center can be much more responsive to whatever

problems you are facing without regard to whether MELD score is at a

arbitrary level. Intractable itching, persistent infections, major

bleeds may be contributing factor that make doing a transplant now a

better option than waiting to do it later. Statistically a person

with a MELD of 15 or more has a better outlook with a transplant

than without one. But each of us is a individual who may fall

outside that statistical norm.

> Do you know how long a person has to be at the same MELD number

before

> it's considered " their " number?

Your MELD score is based on your latest tests and can be used for

UNOS listing until a retesting is required, 1 week if 25+, 1 month

if 19-24, 3 months if 11-18, 1 year if 0-10 (3.6.4.1.1 Adult

Candidate Reassessment and Recertification Schedule - Organ

Distribution: Allocation of Livers,

http://www.unos.org/policiesandbylaws/policies.asp?resources=true).

There are some other rules about how recent the lab values must be

etc. but essentially your MELD is yours until it must be recertified.

> This part of the process is still very confusing to me. If a MELD

> score is 15 one month, but the very next month dropped down to a

> 7, what is their MELD score - a 7?

It could be, but under those circumstances you would not have to

submit your " new " score since you can use the 15 MELD score for 3

months. But if you are getting tested every month and have a series

of 15, 7, 14, 11 you would be reassessed with a MELD of 11 in the

3rd month, the 14 would be too old to use (at that level the tests

can't be more than 14 days old to be submitted).

> Does the MELD number have to consistently go up

> (and never back down) in order to get a transplant? Or does it

have to

> stay the same for a certain length of time in order for that to be

> " their " score?

No, MELD can fluctuate up and down, it is just more likely that your

MELD will be highest when it is up, so the chance of getting a

transplant is greater. It is possible to be the highest on the list

even if your most recent MELD is down from the previous value.

The " list " is regenerated each time a liver becomes available -

based on blood type, liver size, MELD score, waiting time, ...

HTH

Tim R