MELD和PELD评分标准及其计算方法
he United Network for Organ Sharing (UNOS), a non-profit charitableorganization, operates the Organ Procurement and Transplantation Network
(OPTN) under federal contract. On an ongoing basis, the OPTN/UNOS
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evaluates new advances and rearch and adapts the into new policies to
best rve patients waiting for transplants.
As part of this process, the OPTN/UNOS developed a system for prioritizing
candidates waiting for liver transplants bad on statistical formulas that are
very accurate for predicting who needs a liver transplant most urgently.
The MELD (Model for End Stage Liver Dia) is ud for candidates age 12
and older and the PELD (Pediatric End Stage Liver Dia Model) is ud
for patients age 11 and younger.
This document will explain the system and how it affects tho needing a transplant.
What is MELD? How will it be ud?The Model for End-Stage Liver Dia (MELD) is a numerical scale, rangingboilerplate
from 6 (less ill) to 40 (gravely ill), ud for liver transplant candidates age 12
and older. It gives each person a 'score’ (number) bad on how urgently he
or she needs a liver transplant within the next three months. The number is
calculated by a formula using three routine lab test results:
I bilirubin, which measures how effectively the liver excretes bile;
I INR (prothrombin time), which measures the liver’s ability to make blood
clotting factors; and
I creatinine, which measures kidney function. (Impaired kidney function is
often associated with vere liver dia.)
plasticsurgeryThe only priority exception to MELD is a category known as Status 1. Status 1 patients
have acute (sudden and vere ont) liver failure and a life expectancy of针织衫怎么搭配
hours to a few days without a transplant. Less than one percent of liver车门隔音
transplant candidates are in this category. All other liver candidates age 12
and older are prioritized by the MELD system.
A patient’s score may go up or down over time depending on the status of his
or her liver dia. Most candidates will have their MELD score assd a
number of times while they are on the waiting list. This will help ensure that
donated livers go to the patients in greatest need at that moment.
美国器官移植共享网－一个非营利的慈善组织，在联邦体制下运行器官切取和移植方面的网络。在不断前进的基础之上，OPTN/UNOS对新的进展和研究进行了评价，使之适应新的政策，以便更好的为等待移植患者服务。作为此项计划的一部分，OPTN/UNOS提出了一种新系统，以便更好的对等待肝移植患者进行划分等级，该系统是建立在统计公式基础之上，可以非常精确的估计哪个患者更迫切需要肝移植。MELD（终末期肝病模型）用于年龄>=12岁的患者， PELD （小儿终末期肝病模型）用于年龄<=11岁患者。
什么是MELD？怎样使用MELD？
MELD是一个从6（轻微疾病）到40（严重疾病）变化的数字范围，用于年龄>=12岁的等待移植的患者，其在他或她在三个月内需要肝移植的迫切程度的基础上，给了每个人一个分数（数字）。这个数字是根据三个常规的实验室检查结果通过一个公式计算出来的：
胆红素：检查肝脏分泌胆汁的功能
国际标准化比率（凝血酶原时间）：检查肝脏生成凝血因子的能力
肌酐：检查肾脏功能（与严重肝脏疾病相关的肾功能损害）
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MELD唯一例外优先的是这种情况：这种该患者有急性肝衰（突发或起病严重），如果没有移植的话，其与其寿命只有几个小时到几天。仅仅有不到1%的患者属于这种情况。所有其他年龄>=12岁的患者是按照MELD系统进行评估的。
一个患者的分数可能会根据其肝脏疾病的状况升高或者降低。大部分等待肝移植患者，会对其进行多次MELD评分。这样可以确保供肝能够给与那些最需要的患者。
What is PELD? How does it differ from MELD?
Candidates age 11 and younger are placed in categories according to the
Pediatric End-stage Liver Dia (PELD) scoring system. Again there is a Status 1
category for highly urgent patients, reprenting about one percent of tho
listed. All other candidates in this age range receive priority through PELD.
PELD is similar to MELD but us some different factors to recognize the specific
growth and development needs of children. PELD scores may also range higher
or lower than the range of MELD scores. The measures ud are as follows:
I bilirubin, which measures how effectively the liver excretes bile;
现状英文I INR (prothrombin time), which measures the liver’s ability to make blood
clotting factors;
I albumin, which measures the liver’s ability to maintain nutrition;
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I growth failure; and
I whether the child is less than one year old.
As with MELD, a patient’s score may go up or down over time depending on
the status of his or her dia. Most candidates will have their PELD score
assd a number of times while they are on the waiting list. This will help
ensure that donated livers go to the patients in greatest need at that moment.
PELD是什么？其和MELD的区别在哪里？
年龄<=11岁患者根据peld评分系统划分为一类。同样，也有一种高危患者属于例外，在等待移植患者中仅占不到1%.所有该年龄段的其他患者都可以通过peld进行划分。peld与meld相似，但是考虑到儿童生长发育的需要，使用一些不同的因子。peld与meld评分一样，也可能升高或下降。使用指标如下：
角色扮演英文
胆红素：检查肝脏分泌胆汁的功能
国际标准化比率（凝血酶原时间）：检查肝脏生成凝血因子的能力
trimming
