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

Predicts short-term mortality in chronic liver disease to guide UK transplant listing.

United Kingdom Model for End-Stage Liver Disease (UKELD)
INR
Values below 1.0 are entered as 1.0 to avoid a negative logarithm.
Serum creatinine
µmol/L
Serum bilirubin
µmol/L
Serum sodium
mmol/L
Complete the fields above to see the result.

When to use

  • Estimating one-year mortality without transplantation in adults with chronic liver disease being assessed for elective liver transplant listing.
  • Applying the UK national minimum listing criterion (UKELD >=49) used by NHS Blood and Transplant.

Formula

UKELD = 5.395 x ln(INR) + 1.485 x ln(creatinine, µmol/L) + 3.13 x ln(bilirubin, µmol/L) - 81.565 x ln(sodium, mmol/L) + 435. INR values <1.0 are entered as 1.0. Score is rounded to the nearest whole number.

Pearls and pitfalls

  • Derived from UK Transplant Registry data specifically to set the national minimum listing threshold, unlike MELD which was derived to predict mortality after TIPS.
  • Incorporates serum sodium, which independently predicts waiting-list mortality in cirrhosis.
  • A UKELD of 49 corresponds to an approximate 9% one-year mortality risk without transplantation and is the UK national minimum listing criterion; exceptions exist for specific indications (e.g. hepatocellular carcinoma, some metabolic diseases).

References

  1. Barber K, Madden S, Allen J, Collett D, Neuberger J, Gimson A. Elective liver transplant list mortality: development of a United Kingdom end-stage liver disease score. Transplantation. 2011;92(4):469-476.