American Board of Internal Medicine (ABIM) Certification Practice Exam

What MELD score indicates better survival with liver transplantation in patients with cirrhotic-stage liver disease?

1. 10 or greater

2. 15 or greater

3. 20 or greater

4. 25 or greater

The correct answer is: 15 or greater

A MELD score of 15 or greater is the threshold that indicates better survival outcomes with liver transplantation in patients with cirrhotic-stage liver disease. The Model for End-Stage Liver Disease (MELD) score is a scoring system used to assess the severity of chronic liver disease and prioritize patients for liver transplantation based on their likelihood of survival. Higher MELD scores reflect more severe liver dysfunction and correlate with increased mortality risk. A MELD score of 15 signifies severe liver disease status, at which point transplantation can significantly improve survival rates. As the MELD score increases beyond this threshold, the urgency for transplant becomes more pronounced, with patients having a greater risk of imminent liver failure. Lower MELD scores, such as those below 15, may suggest a less severe disease state where the immediate need for transplantation is not as critical, which can lead to poorer outcomes if transplantation is performed prematurely. Therefore, a MELD score of 15 or greater effectively identifies patients who are at an increased risk of mortality and who would benefit the most from the life-saving potential of liver transplantation.