![]() ![]() Chronic liver disease in COVID-19 patients.These values are then put into a formula that gives the MELD Score. MELD involves a few simple blood tests including creatinine (for kidney health), bilirubin (liver function assessment) and INR (blood coagulation profile assessment). The final allocation is made based on a system called the Model for End Stage Liver Disease (MELD). Each patient on the list are listed as per their height, body weight and blood group. Usually a national system like the United Network for Organ Sharing (UNOS) organizes collection and distribution of deceased donor organs along with organizations like Organ Procurement Organizations. Once a patient has been accepted for liver transplant and undergoes the initial evaluation they are placed on the waiting list. Allocation of the organ from deceased donors Patients with drug or alcohol problems need to be helped to develop a plan prior to transplant to prevent a relapse after the operation. Other tests include tests for viral hepatitis, HIV infection, liver function tests, blood coagulation tests, blood group and type. These determine general fitness as well as fitness to withstand general anesthesia and the major surgery. General work up includes chest X ray, routine blood and urine tests and electrocardiography (ECG). In addition, a social worker and psychiatrist meet with the patient as well as the family for motivation and support. Usually a liver specialist or hepatologist and a transplant surgeon along with other specialists like heart specialist, infectious disease specialists, and chest specialists are involved in this assessment. The patient’s general health condition and ability to withstand a major surgery is evaluated. The patient’s liver disease undergoes a detailed evaluation. 1-5 Evaluation and management for being placed on the waiting list The first step in this is often a rigorous assessment and being placed on a waiting list. When a patient presents with end stage liver disease or liver failure he or she may be considered for a liver transplantation. Ananya Mandal, MD Reviewed by April Cashin-Garbutt, MA (Editor) ![]()
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