Brief Answer:
child turgotti pugh crieria is much better for you then MELD.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query,

The Model for End-stage Liver Disease, created from a cohort of patients undergoing transjugular intrahepatic portosystemic shunts has been demonstrated to be an excellent predictor of survival in patients with end-stage liver disease . The MELD score is derived from the International Normalized Ratio (INR) of prothrombin time, serum creatinine, and serum total bilirubin using the following formula:

MELD=9.57*in(cr) +3.78* In(bilirubin)+
11.20*IN (INRi+6.43

Of the three variables in the MELD score, the INR carries the most weight. Therefore, it is important that the INR be measured reliably. An inappropriate determination of the INR would result in an incorrect MELD score, thereby putting some patients listed for liver transplantation at a disadvantage.


The liver specific causes of an incorrect INR are related to the fact that the ISI has been standardized for patients on warfarin therapy.Since patients with liver disease have more complex coagulopathy, the ISI as calibrated for camoudrin applicable to liver disease.

Currently, the ISI used in clinical laboratories to calculate the INR is not calibrated based on prolongation of prothrombin time in patients with chronic liver disease. As a result, variation in the conventionally measured INR (using cougalants so determine the thromboplastin ISI) has been well-documented in liver disease patients. In spite of this limitation, virtually every study that has looked at the MELD score as a predictor of survival has demonstrated that the MELD score using the conventional INR possesses excellent survival discrimination.But as told by your gastroenterologist acuuracy is markedly decreased.If the ISI is calculated from standards based on chronic liver disease to provide the INRliver, it is likely to provide an even more accurate measurement. It is anticipated that in the future the variations in the prothrombin time and, therefore, the MELD score from laboratory to laboratory will be greatly reduced by incorporation of this technique. Meanwhile, the current MELD calculation using a conventionally determined INR remains a proven, valid and clinically useful tool in predicting survival in end stage liver disease.

So take homemessage is that as you are on anticoagulants it is not a test of choice for you go for Child turcotti pugh score.

I hope i answered your query well,Feel free to question if you fail to understand any thing.

Take home message-The long term prediction of mortality or removal from waiting list in patients awaiting liver transplantation might be better assessed by the CTP child turcotti pugh score. This might have implications for the development of new improved scoring systems.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
I am sorry i tried to make it as simple as i can but you know these are all supspeciality tests and are very difficult to explain fully to a lay man.

Yes i do agree with your gastroenterologist.Apart from INR value of MELD depends on factors like Prothrombin time etc. So its very likely that results can be altered due to drug.
Your PT was 20.5 way above normal(again giving you faulty results).


Advice
Child turgotti pugh crieria


Thanks

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