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

Why Use

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

When to 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).

Formula

Pearls / Pitfalls

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.

Management

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

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.

More Information

Interpretation: UKELD Score of ≥49 is the cutoff for transplant eligibility in UK, which corresponds to 1-year mortality of >9% without transplantation. UKELD Score of 60 is predictive of 50% 1-year mortality.