How is the MELD score calculated?

MELD = 3.78 × ln(bilirubin mg/dL) + 11.2 × ln(INR) + 9.57 × ln(creatinine mg/dL) + 6.43. Lab values below 1.0 are rounded up to 1.0. Maximum creatinine is capped at 4.0. If dialysis ≥ 2 times in the past week, creatinine is set to 4.0. MELD ranges from 6 to 40.

What MELD score qualifies for liver transplant?

Patients with MELD ≥ 15 generally benefit from liver transplantation (expected post-transplant survival exceeds predicted survival without transplant). Higher MELD scores receive priority on the transplant waiting list. Exception points may be granted for hepatocellular carcinoma and other standardized conditions.

MELD-Na incorporates serum sodium into the MELD score to improve mortality prediction, as hyponatremia (common in cirrhosis due to fluid retention) independently predicts mortality. MELD-Na = MELD − Na − [0.025 × MELD × (140 − Na)] + 140. Sodium values are bounded between 125 and 137 mEq/L. MELD-Na replaced MELD for transplant allocation in January 2016.

Zurück zu allen Tools

Startseite / MELD

MELD / MELD-Na Calculator

Model for End-Stage Liver Disease (MELD) and MELD-Na scores for chronic liver disease severity and transplant prioritization contexts.

Eingaben

Total bilirubin (mg/dL)

INR

Creatinine (mg/dL) Capped at 4.0 mg/dL; minimum 1.0 mg/dL in MELD formula.

Sodium (mmol/L) For MELD-Na: Na is clamped to 125–137.

Dialysis (at least twice in past 7 days) (set creatinine to 4.0)

—

Enter labs to calculate MELD and MELD-Na.

MELD—

MELD-Na—

Approx. 90-day mortality—

Notes—

Haftungsausschluss: Nur zu Bildungszwecken. Kein Ersatz für klinisches Urteil. Transplant allocation rules vary; use the score definitions required by your program and jurisdiction.

Verwendete Formeln

MELD: 3.78·ln(bilirubin) + 11.2·ln(INR) + 9.57·ln(creatinine) + 6.43 (labs minimum 1.0; creatinine max 4.0; dialysis → creatinine=4.0)
MELD-Na (UNOS): MELD + 1.32·(137−Na) − 0.033·MELD·(137−Na), with Na clamped 125–137

Mortality estimates

Approximate 90-day mortality is often cited by MELD ranges (not MELD-Na). Estimates vary by cohort and era.

References

Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001.
Biggins SW, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2006.
UNOS/OPTN MELD-Na policy documentation (formula definition).

Related tools

Über dieses Tool

What Is the MELD Score?

The Model for End-Stage Liver Disease (MELD) score is an objective, continuously variable severity score for chronic liver disease. Originally developed by Kamath et al. in 2001 to predict survival after TIPS procedures, it was adopted by UNOS in 2002 for liver transplant allocation in the United States. The score uses serum bilirubin, INR, and creatinine in a logarithmic formula. MELD-Na incorporates serum sodium — recognizing that hyponatremia independently predicts mortality in cirrhosis — and has been used for transplant allocation since 2016.

When to Use MELD/MELD-Na

Calculate MELD in all patients with chronic liver disease to assess severity, guide transplant listing decisions, and estimate short-term (90-day) mortality. It is also useful for prognostication in acute-on-chronic liver failure, assessing urgency of TIPS procedures, and guiding decisions about elective surgery in cirrhotic patients. MELD-Na should be used when serum sodium is available, as it provides improved prognostic accuracy over classic MELD.

Interpreting MELD Results

MELD ranges from 6 to 40 in clinical practice. Scores <10 carry low 90-day mortality (~1.9%), while scores ≥30 indicate very severe disease with mortality >50%. In the transplant context, higher MELD scores confer higher priority for organ allocation. The MELD exception points system addresses conditions where MELD underestimates disease severity (e.g., hepatocellular carcinoma, hepatopulmonary syndrome).

🔑 Klinische Hinweise

MELD uses lab floors (bilirubin, INR, creatinine minimum 1.0) and a creatinine ceiling of 4.0 mg/dL. Patients on dialysis have creatinine set to 4.0.
MELD-Na clamps sodium between 125 and 137 mEq/L. Sodium below 125 does not further increase the score.
MELD does not capture complications like hepatic encephalopathy, variceal bleeding, or ascites that significantly impact quality of life and prognosis — these are addressed by exception points.
The newer MELD 3.0 (adopted by UNOS in 2022) incorporates albumin and female sex to reduce sex-based disparities in transplant access.

Schlüsselreferenzen

Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464–470.
Biggins SW, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130(6):1652–1660.
Kim WR, et al. MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era. Gastroenterology. 2021;161(6):1887–1895.e4.

Formel zuletzt überprüft: Februar 2026