Liver Transplant

[Billie79]

Hello Everyone,

I am posting concering a family member that has be diagnosed with Cryptogenic Liver Cirrhosis.  We have consulted with the transplant team and at this point, this family member is “too good” to receive a transplant.  There score is 10/15.  What does this mean?  I have been looking through a number of scoring criteria and none end in 15?  I looked at the “MELD” score and “PELD” scoring, these do not seem to apply.  Any direction?   Also, anyone in this situation?  We have been told to “monitor” this family member; I am not sure what this entitles, beyond monitoring edema and checking for jaundice.  Can anyone provide direction as to key symptoms that we should look out for?  We have been told we may need to return to consult with the team any time.

Any direction is welcome.

Thanks
Billie :o)

[Thomas D Schiano, MD]

i presume that they mean that the MELD score is between 10-15.  screening for liver cancer is important as well monitoring for complications of the chronic liver disease i.e. encephalopathy, ascites, bleeding, malnutrition.  Please refer to mayo clinic MELD calculator on-line.

[Thomas D Schiano, MD]

i think that you should definitely see nthe transplant physician with regard the MELD score and the monitoring.  What you describe can definitely be early symptoms of hepatic encephalopathy.

[Billie79]

Hello Dr. Schiano,

Thank you for your direction.  There is no cancer however there was a bleed and enlarged spleen.  We continued to monitor the symptoms closely including edema and jaundice.  Her score at this point is a 10 on the MELD.  Beyond ultrasound and an endoscopy every 6 months do you have any further recommendations for testing?  I also understand there can be an underlying cognitive component to be aware of.  How pronounced are the cognitive changes?  Right now I am just noticing slight short term memory impairment, however I am not sure if I am just being over analysing things.  Finally, can the GP provide direction on the MELD score or will we need to continue to see the specialist for this?

Thank you in advance for you direction.

Billie :o)