Deciding on the Best Treatment Option for Patients with Hepatocellular Carcinoma: The Role of MELD Score and Life Expectancy

Liver transplantation (LT) is widely regarded as the most effective treatment option for patients with end-stage liver disease, including those suffering from hepatocellular carcinoma (HCC). However, its effectiveness is limited by various factors, including technical demands, shortage of deceased donors, and ethical concerns related to living donor liver transplantation (LDLT).

In this context, the MELD score has emerged as a crucial factor in determining the allocation of organs for LT. The MELD score takes into account the patient's serum bilirubin level, international normalized ratio (INR), and creatinine level to predict their mortality risk within three months. For patients with HCC, a MELD score of 12 is often used as a threshold to determine their eligibility for LT.

Recent studies have highlighted the significance of considering life expectancy in addition to MELD score when deciding on the best treatment option for patients with HCC. A patient's life expectancy can be influenced by various factors, including their age, overall health status, and tumor characteristics. In particular, patients with a higher MELD score (12 or above) are more likely to have a shorter life expectancy, which may impact their decision-making process regarding LT.

To balance competing principles and ensure equitable allocation of organs, many experts advocate for allocating organs based on transplant benefit rather than solely relying on the MELD score. This approach considers not only the patient's medical condition but also their likelihood of benefiting from LT in terms of improved quality of life and survival rates.

In conclusion, deciding on the best treatment option for patients with HCC requires careful consideration of multiple factors, including MELD score, life expectancy, and transplant benefit. By incorporating these factors into the decision-making process, healthcare providers can ensure that patients receive optimal care and that organs are allocated in a fair and equitable manner.

Meld score 12 life expectancy