A set of improvements to MELD, PELD, Status 1A and 1B is in effect as of July 13, 2023. The changes include:
- Updates to calculation of both the MELD and PELD formulas
- Revised qualification criteria for pediatric Status 1A and 1B candidates
- Updates to NLRB guidance for pediatric candidates
Liver transplant programs should ensure that their candidates have appropriate lab values and other information entered to support the new score calculations. Programs may need to update lab tests or get additional information from the transplant candidate to ensure they have the most current and complete information.
Some candidates may require recertification on a different schedule based on their new score. Any candidates that have missing values for required data will have a MELD or PELD lab score of “null,” and their allocation status will default to a MELD or PELD of 6.
Updated and new data fields
- For all current transplant candidates of any organ type, the data field previously labeled “Gender” in all WaitlistSM and TIEDI® forms is now labeled “Birth sex.” This is an automatic update of the field title and does not affect the data value currently entered for any candidate.
- A new field, “Sex for Purposes of Adult MELD Calculation,” has been introduced for all adult liver candidates (age 18 or older at the time of registration). This field is now required for all new adult candidate registrations. it may be edited for adult candidates already on the OPTN Waiting List. The field will not apply to any pediatric candidates, even if those candidates have a MELD score.
- An albumin value is now required for all MELD candidates.
- A creatinine value is now required for all PELD candidates.
The OPTN Liver and Intestinal Organ Transplantation Committee and Pediatric Transplantation Committee hosted three recent webinars. Two were intended primarily for liver transplant program staff, while the third was focused on liver transplant patients and caregivers. Recordings of each of the webinars can be found here.
A new educational course is now available in UNOS Connect, the OPTN’s learning management system. The course number and title are: LIV114: Preparing for MELD 3.0 and PELD Cr
Resource section, MELD and PELD calculators on OPTN website
A section addressing the policy changes is located at the top of the Liver and Intestine professional resources page on the OPTN website. It contains frequently asked questions for both liver transplant clinicians as well as liver transplant patients and caregivers. It also houses a guide to calculating the updated MELD and PELD scores.