Model for End-Stage Liver Disease (MELD) Score as a Biomarker

End-stage liver disease (ESLD) due to cirrhosis carries a high mortality. Previ-ous methods to quantify the risk of death in these patients were subjective. The model for end-stage liver disease (MELD) score was developed and is an accurate biomarker of 90-day mortality in patients with ESLD, essentially measuring how sick a patient is. The MELD score incorporates serum bilirubin, creatinine, and INR in a mathematical formula. Since 2002, the MELD score has been used to prioritize deceased donor organ allocation for patients listed for liver transplantation (LT) in the USA. The use of the MELD allocation system has resulted in sicker patients being transplanted with decreased waiting time, therebydecreasingthedeathrateontheLTwaitinglist,withoutanadverse effect on posttransplant outcome. The MELD score has been adopted as a biomarker with good effect in other situations where patients with ESLD have a high risk of dying such as surgery, alcoholic hepatitis, acute liver failure, and variceal bleeding. Since the MELD score was introduced, there have been several modifications that may have increased effectiveness in certain situa-tions. The MELD score is not an accurate biomarker for the risk of death from liver cancer and some other conditions, and hence for the purposes of liver allocation on the transplant list, an exception to the calculated MELD score can be given.