Liver Transplant Expert Forum
Calculating MELD score with HCC exception points
About This Forum:

Questions posted in the Liver Transplant . Forum are answered by medical professionals from The Mount Sinai Medical Center.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Calculating MELD score with HCC exception points

Dear Dr. Schiano,

I am confused about how many MELD HCC exception points are added every three months.
Can you explain to me how MELD score HCC exception points are calculated every 3 months?

I started with a MELD score of 22 after HCC was found during a MRI. After that 3 points were added every three months. When I reached 28 points I only receive 1 point every three months.

Could this be related to having both of my tumors downsized using Doxorubicin TACE treatments and haven't had any new tumors since March of 2012? My AFP is about 100 if that makes any difference.

It has been 17 months since I was first diagnosed with HCC. My current MELD score is 30. I will have another MRI in December and hope to add at least one point. Hopefully that will be enough to get me on some backup transplant lists. My transplant center (UCSF) usually doesn't transplant until the mid to upper 30s.

Thank you for your expertise.
Cheers!
HectorSF
517301_tn?1229801385
hector, this is the typical way that exception points are added for thr HCC variance.  this is done nationally--unfortunately in most regions of the country except CA, NY, MA people will get transplanted with lower MELD scores than this.  our patients go through the same type of waitng.  I am glad that the HCC is well treated.  good luck.
3 Comments
Blank
446474_tn?1404424777
Thank you for your answer doctor. It is reassuring to know that this is the UNOS standard and that many others are managing their lives with the same issue as well. It is not a good position to be in but with advanced liver disease, I have found that many times there are no "good" options, just the best choice of the "bad" options.

I am aware that am very luckily to have such a great team of transplant doctors led by Dr. Norah Terrault at UCSF who are pulling for me and monitoring my condition closely. Should my cancer become unmanageable we have a backup plan for me to go to another center that has lower MELD score requirements, where I am also listed.

Thank you haven chosen to spend your life and career helping others who are dealing with the challenges of liver disease. I know myself and my fellow transplant patients are eternally grateful for the work that people like yourself do.

Cheers!
HectorSF
Blank
517301_tn?1229801385
dr terrault is excellent hector.  you are in very good hands
Blank
Blank
Request an Appointment
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank