MELD and MELD-XI Scores

Model for End-Stage Liver Disease or MELD score is a logarithmic function of creatinine, total bilirubin, and International Normalized Ratio. MELD score was originally developed to assess prognosis in patients undergoing transjugular intrahepatic portosystemic shunts for cirrhosis liver. Later MELD score has been used in cardiovascular conditions like patients undergoing left ventricular assist device placement to operative transfusion requirements, morbidity, and mortality. An important limitation for using MELD score in cardiovascular conditions is that the INR value does not indicate liver function in those receiving warfarin. Hence a new score – MELD score eXcluding INR (MELD-XI score) was developed and validated.