When is a patient too well and when is a patient too sick for a liver transplant?

Key Points 1 Liver transplantation is currently offered as a therapeutic option for patients with a wide range of end‐stage liver diseases. 2 Conventional wisdom suggests that patients who receive a liver transplant have a greater expected lifetime when compared to comparable candidates on the waiting list. 3 The model for end‐stage liver disease (MELD) scoring system is an excellent predictor of mortality on the waiting list and also predicts mortality after liver transplantation. 4 The combination of waiting list mortality risk and posttransplant mortality risk assessed by MELD and other factors can be used to estimate whether candidates are likely to derive a survival benefit from a liver transplant. (Liver Transpl 2004;10:S69–S73.)