What Degree of Liver Failure Necessitates a Liver Transplant?

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We approach liver transplantation the same way we would do any medical or surgical therapy, and it should be considered when the risks of dying with liver disease are greater than the risks of dying with a liver transplant. Currently the survival after liver transplantation is about 90% at one year, and 85% at five years in well selected individual, thus we recommend pursuing transplantation, when the risk of dying from the liver disease is greater that 10% at one year, this includes patients with a med score if you know your meld score of greater than 10, or a child's pugh class of B.

We use the meld score to both decide when patients should be listed and to prioritize them on the waiting list. The meld score stands for models for end stage liver disease, and comply as a complex equation of three simple lab tests, the bilirubin or a measure of juandice, the I and R are a measure of the liver's ability to make clotting factors, and the coronary which measures renal functions. With logarithms we create a single number that goes from 6 to 40, 6 being the best, 40 being the sickest, and we allocate livers from the bigger meld score downwards, so anyone with a meld score over 10 has a risk of the waiting list that exceeds that of transplantation.