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    United Kingdom Model for End-Stage Liver Disease (UKELD)

    Predicts mortality in end-stage liver disease patients for transplant planning (UK-specific).
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    INSTRUCTIONS

    Use in context of national liver transplantation guidelines. In the UK, refer to NHS Blood and Transplant policy.

    When to Use
    Pearls/Pitfalls
    Why Use

    • Use to determine eligibility in patients with chronic liver disease awaiting transplant.

    • Do not use in patients awaiting transplant for other causes (e.g. HCC, acute liver failure).

    • UKELD was developed and validated in a UK population and should only be considered for use in the UK.

    • It was validated in a UK population of patients with chronic liver disease awaiting transplantation. Patients with HCC were excluded.

    • A cutoff of 9% 1-year mortality was used, as this was the 1-year mortality after liver transplantation in the UK at the time.

    • Interlaboratory differences may lead to variation in end-stage liver disease scores. For example, for the transplant center Royal Free Hospital in London, creatinine clearance is weighted differently and a local correction must be used to get valid results.

    Helps decide if a patient with chronic liver disease is eligible for liver transplantation in the UK.

    mg/dL
    mg/dL
    mEq/L

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    • Consult a hepatologist to help determine if patient may be eligible for transplantation for reasons other than chronic liver disease.

    • For patients meeting eligibility cutoff in the UK (score ≥49), contact local transplantation center with the locally agreed upon referral system.

    Management

    Most hospitals have a particular method for transplantation referring. Typically, this is done through referral via hepatology or gastroenterology services.

    Content Contributors
    • Andrew Baxter, MB ChB, MRCP(UK)
    About the Creator
    Dr. James M. Neuberger
    Are you Dr. James M. Neuberger?
    Content Contributors
    • Andrew Baxter, MB ChB, MRCP(UK)