Volume 140, Issue 7, Pages 1952-1960 (June 2011) A Revised Model for End-Stage Liver Disease Optimizes Prediction of Mortality Among Patients Awaiting Liver Transplantation  Michael D. Leise, W. Ray Kim, Walter K. Kremers, Joseph J. Larson, Joanne T. Benson, Terry M. Therneau  Gastroenterology  Volume 140, Issue 7, Pages 1952-1960 (June 2011) DOI: 10.1053/j.gastro.2011.02.017 Copyright © 2011 AGA Institute Terms and Conditions

Figure 1 The relation between risk of 90-day mortality and individual Model for End Stage Liver Disease (MELD) variables. (A) The pattern for serum bilirubin in the 2005–2006 data (adjusted for creatinine and international normalized ratio [INR]). (B) ReFit bilirubin coefficient (lower bound = 1.0 mg/dL) superimposed on (A). (C) The pattern for serum creatinine in the 2005–2006 data (adjusted for bilirubin and INR). (D) ReFit creatinine coefficient (lower bound = 0.8 mg/dL, upper bound = 3.0 mg/dL) superimposed on (C). (E) The pattern for serum INR in the 2005–2006 data (adjusted for bilirubin and creatinine). (F) ReFit INR coefficient (lower bound = 1.0, upper bound = 3.0) superimposed on (E). Gastroenterology 2011 140, 1952-1960DOI: (10.1053/j.gastro.2011.02.017) Copyright © 2011 AGA Institute Terms and Conditions

Figure 2 The relation between serum sodium concentration and the relative risk of death after adjustment for the ReFit Model for End Stage Liver Disease (MELD) score. Gastroenterology 2011 140, 1952-1960DOI: (10.1053/j.gastro.2011.02.017) Copyright © 2011 AGA Institute Terms and Conditions

Figure 3 Comparison of model fit in the validation data (2007–2008): The refit coefficient (blue) fits the 2007–2008 data better than the current Model for End Stage Liver Disease (MELD) (green) and Scientific Registry of Transplant Recipients (SRTR) MELD (red) for all variables. (A) Bilirubin. (B) Creatinine. (C) International normalized ratio (INR). Gastroenterology 2011 140, 1952-1960DOI: (10.1053/j.gastro.2011.02.017) Copyright © 2011 AGA Institute Terms and Conditions

Figure 4 Correlation between the existing Model for End Stage Liver Disease (MELD) MELD and refit Model for End Stage Liver Disease-Sodium (MELDNa) scores in the validation dataset (2007–2008). The horizontal and vertical lines represent 3816 livers that were available within the first 90 days of listing. Gastroenterology 2011 140, 1952-1960DOI: (10.1053/j.gastro.2011.02.017) Copyright © 2011 AGA Institute Terms and Conditions