Sibulesky L, Leca N, Blosser C, Rahnemai-Azar AA, Bhattacharya R, Reyes J. Is MELD score failing patients with liver disease and hepatorenal syndrome? World J Hepatol 2016; 8(27): 1155-1156 [PMID: 27721921 DOI: 10.4254/wjh.v8.i27.1155]
Corresponding Author of This Article
Lena Sibulesky, MD, Assistant Professor, Department of Surgery, Division of Transplant Surgery, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, United States. lenasi@uw.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letters To The Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 28, 2016; 8(27): 1155-1156 Published online Sep 28, 2016. doi: 10.4254/wjh.v8.i27.1155
Is MELD score failing patients with liver disease and hepatorenal syndrome?
Lena Sibulesky, Nicolae Leca, Christopher Blosser, Amir A Rahnemai-Azar, Renuka Bhattacharya, Jorge Reyes
Lena Sibulesky, Amir A Rahnemai-Azar, Jorge Reyes, Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, WA 98195, United States
Nicolae Leca, Christopher Blosser, Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA 98195, United States
Renuka Bhattacharya, Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, WA 98195, United States
Author contributions: Sibulesky L wrote the paper and designed and conducted research; Leca N, Blosser C, Rahnemai-Azar AA, Bhattacharya R and Reyes J designed research and reviewed the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest. No funding was received for this research.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lena Sibulesky, MD, Assistant Professor, Department of Surgery, Division of Transplant Surgery, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, United States. lenasi@uw.edu
Telephone: +1-206-5987797 Fax: +1-206-5984287
Received: May 26, 2016 Peer-review started: May 26, 2016 First decision: July 6, 2016 Revised: July 22, 2016 Accepted: August 6, 2016 Article in press: August 8, 2016 Published online: September 28, 2016 Processing time: 118 Days and 16.9 Hours
Abstract
There is a need to reassess the application of MELD and the impact of renal insufficiency with consideration for developing an algorithm with exception points that would lead to timely allocation of livers to patients with hepatorenal syndrome prior to occurrence of permanent renal damage without jeopardizing post-transplant survival.
Core tip: The decompensation of patients with cirrhosis is associated with the development of hepatorenal syndrome (HRS) and renal insufficiency. There are several consequences of a high serum creatinine level in cirrhotic patients, including increased post - liver transplant mortality and increased risk of non-reversal of renal insufficiency/renal failure. We propose a change to the MELD scoring that would lead to timely liver transplantation in patients with HRS.
