Lisa,
the MELD is a score that they have found pretty much tells them how sick the person is.
It uses numbers for Bilirubin, Creatinine, and the INR.
Once the liver is decompensated (doesn't work for whatever reason), the body starts to have problems doing its jobs. Two really bad problems is that the platelets drop off to a dangerous level and the blood does not clot properly. They can keep an eye on this with the Platelet and INR scores. In addition, the decompensated liver starts to cause problems with the excretion of wastes through the kidneys. The bilirubin and creatinine measure the level of those wastes stuck in the blood and not excreted. The way the patient can observe the failing kidneys is when the urine becomes dark yellow, then eventually brown like coke.
So the MELD is a fancy math formula that calculates how sick the person is using these three markers in the blood.
As the cirrhosis progresses, the other body functions echo the problems in the blood tests.
So, when you say hubby's MELD was 11, it means his liver is not fully decompensated at this last blood draw and his clotting and kidney function are not at critical stage.
It can change over time.
My Mike's MELD was 24 or 25, I can't remember, when he went for his take down appointment at the Transplant Center in October 2010. They wanted to put him in the hospital at that point and have him wait for a liver under their care as 24 is higher than their average score at transplant -- 22.
BUT, in the fall of 2010, he was only completely sober for 1 month. Had had Hep C for 40 years.
How sad. He needed to be alcohol free for 6 months with documentation from AA or a drug cessation program.
So they gave him the lactulose, xifaxan, lasix, spironolactone, blood pressure meds...the whole standard protocol.
In three months, he went for another check and with NO alcohol and his MELD went down to 16 or 17, again, can't remember exactly...
He was very sick, had 4 hospitalizations, and after one of those, they started his transplant work up. they believed he was committed to his sobriety and wanted to be ready if/when the magical 6 months requirement was met, that he could have the surgery.
The MELD crept up, BUT in February 2011, they found a small tumor in the liver. They waited a couple more months to recheck (with bloods more often), they did another MRI and saw the tumor was growing. They talked to him soooo calmly, urged him to hang on, that he would be next...to please hang on. He was near death and didn't think he could do another day. With the tumor his MELD went to 22 like Connie's did.
But the call came April 30, 2011, he had the surgery and with minor setbacks is doing great. He is just over a year post transplant now and is pretty normal for a guy who's been through so much.
Oh...some centers are using some calculation with sodium level to adjust the MELD score also. They didn't with Mike, but some centers are. I don't know the details.
And there are some tumor guidelines that are not 100 % clear to me...but I think the sum of the tumors cannot be over 5 cm. They can use chemo directly into the liver to shrink a tumor, then transplant, so all is not lost. For us the cancer was what saved him! Only now, he still has Hep C and they say those HCC tumors often come again..even in a new liver. The Hep C creates an environment that is vulnerable to HCC.
From earlier posts, I know different centers have average wait times (on the average) and different average MELD scores. I hear that the VA may require higher MELD scores than civilian programs. But I'm not sure of that. Maybe Debbie can chime in on that.
Good luck...I hope he gets the call soon.
Carol
Post Edited By Moderator (hep93) : 6/23/2012 11:07:15 AM (GMT-6)