The MELD score used in liver transplant allocation in end-stage liver disease incorporates which three laboratory values?

• A Serum bilirubin, albumin, and prothrombin time (INR)
• B Serum sodium, ALT, and INR
• C Serum bilirubin, ALT, and serum creatinine
• D Serum creatinine, INR, and serum bilirubin ✓

Explanation

The Model for End-stage Liver Disease (MELD) score uses three values: serum creatinine (reflecting renal function), INR (reflecting hepatic synthetic function), and serum bilirubin (reflecting liver excretory function). The formula is: MELD = 3.78×ln(bilirubin mg/dL) + 11.2×ln(INR) + 9.57×ln(creatinine mg/dL) + 6.43. The MELD-Na score subsequently incorporated serum sodium to improve prognostication. Albumin is part of the Child-Pugh score, not MELD.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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