Calculateur du MELD 3.0 actuel de l’OPTN pour une inscription avant 18 ans

État

clinical-review-pending

Version de la méthode

Current US OPTN Policy 9.1.D pre-18-registration MELD arithmetic, engine optn-policy-9.1.d-pre18-registration-meld3-2026-06-24, policy checked 2026-08-13: for a candidate currently age 12 or older who was younger than 18 at the applicable continuously maintained waitlist registration, calculate 4.56×ln(total serum bilirubin mg/dL) + 0.82×(137−serum sodium mEq/L) − 0.24×(137−sodium)×ln(bilirubin) + 9.09×ln(INR) + 11.14×ln(serum creatinine mg/dL) + 1.85×(3.5−serum albumin g/dL) − 1.83×(3.5−albumin)×ln(creatinine) + 7.33. This branch has no sex input or sex term. Bilirubin, INR, and creatinine below 1 are set to 1; creatinine above 3 or either qualifying dialysis/CVVHD criterion is set to 3; sodium is limited to 125–137 and albumin to 1.5–3.5. Use natural logarithms without intermediate rounding, round the continuous result arithmetic-half-up to the nearest whole number, then limit the written-policy integer to 6–40. Output is limited to the calculated policy integer, continuous audit value, pre-limit whole number, entered values, policy-adjusted values, adjustment flags, and weighted terms; it does not select a branch or establish an authoritative allocation value, certification, recertification, Status, exception points, priority, mortality, diagnosis, prognosis, or care.

Population

US liver-transplant candidates who are currently age 12 or older and were younger than 18 at the applicable continuously maintained waitlist registration, after the transplant program independently verifies the exact registration identity and date and establishes that current Policy 9.1.D selects this no-sex-term branch. Exact final total serum bilirubin, serum sodium, INR, serum creatinine, serum albumin, official units and laboratory context, and both dialysis/CVVHD criteria for the seven days before the creatinine test must be complete and independently verified. This arithmetic does not establish laboratory certification, recertification, allocation, or the value held in the authoritative OPTN record.

Limites et exclusions

Current age younger than 12; age 18 or older at the applicable waitlist registration; an unknown, discontinuous, or relisted registration history; the adult-at-registration branch; PELD; or selecting a policy branch from current age alone. · Any sex input or sex term; a missing, inferred, imputed, defaulted, carried-forward, mismatched, uncertified, or unverified laboratory value, unit, registration fact, policy context, or dialysis/CVVHD history. · Status 1A or 1B; an exception score; liver-intestine points; certification or recertification; an authoritative allocation value or priority; a match-run result; candidacy, listing, mortality, risk, diagnosis, prognosis, treatment, management, disposition, or another care decision. · Delaying, withholding, or altering indicated albumin, dialysis, CVVHD, anticoagulation, testing, or other care to influence arithmetic; substituting the uncapped research MELD 3.0 output or another policy version.

• https://www.hrsa.gov/optn/policies-bylaws/policies
• https://www.hrsa.gov/sites/default/files/hrsa/optn/optn_policies.pdf
• https://www.hrsa.gov/sites/default/files/hrsa/optn/meld-peld-calculator-user-guide.pdf
• https://www.hrsa.gov/optn/data-calculators/allocation-calculators/meld-calculator
• https://www.hrsa.gov/sites/default/files/hrsa/optn/improving-liver-allocation-pediatric-faq.pdf
• https://pmc.ncbi.nlm.nih.gov/articles/PMC10363200/
• https://www.hrsa.gov/sites/default/files/hrsa/optn/policy-guid-change_impr-liv-alloc-meld-peld-sta-1a-sta-1b_liv.pdf

Outil importé de la bibliothèque PharmaTek de MDose. Aucune date de révision clinique indépendante n’est documentée dans cette version.

Bibliothèque source

PharmaTek · MDose

Version importée

4b66536936ed

État de publication

Révision clinique en cours