Weekly issue 2026-W33 ·
Limitations of MELD in Isolated Polycystic Liver Disease: Fatal Traumatic Cyst Rupture Complicated by Abdominal Compartment Syndrome.
Plain language
A man whose liver was crowded with cysts but whose blood tests looked fine scored too low for a liver transplant. After wasting away he was listed — then a bump burst a cyst and he died. MELD scores can miss real suffering in polycystic liver disease; repeat checks matter.
Clinical note
Single case report (isolated PLD). Illustrates MELD blind spots — mass effect, malnutrition, sarcopenia — and fatal traumatic rupture with compartment syndrome. Exception pathways exist: reassess longitudinally and counsel trauma risk in massive PLD.
Question for your next visit
If liver cysts affect my eating, weight or daily activities despite normal blood tests, how will you assess their impact?