Common Liver Diseases and Transplantation: An Algorithmic Approach to Work Up and Management

Robert S Brown Jr, MD MPH

Chapter 4: Evaluation Of The Transplant Candidate (continued)

Mark W. Russo, MD, MPH, FACG, AGAF

Candidates for liver transplantation undergo a thorough medical, surgical, psychosocial, and financial evaluation prior to listing for transplantation. The Model for End-Stage Liver Disease (MELD) is used to prioritize patients for liver transplantation with the fundamental concept of giving organs to the sickest first. The MELD score is calculated based on serum total bilirubin, creatinine, and international normalized ratio. However, exceptions exist, such as patients with hepatocellular carcinoma who are within Milan criteria. Because of the organ shortage and wait list mortality in many…