MELD Score
Calculate MELD and MELD-Na scores for liver transplant prioritization using bilirubin, creatinine, INR, and sodium. Get 3-month mortality estimates and clinical interpretation with charts.
About This Calculator
The Model for End-Stage Liver Disease (MELD) score calculator helps patients, caregivers, and healthcare professionals assess the severity of chronic liver disease and prioritize liver transplant candidates. This is a free, evidence-based tool that uses standard laboratory values to compute your MELD and MELD-Na scores, providing estimates of 90-day (3-month) mortality and clinical urgency.
Since its adoption by the United Network for Organ Sharing (UNOS) in 2002, the MELD score has been the standard for liver allocation in the United States. The 2016 MELD-Na update incorporated serum sodium, which independently predicts mortality in cirrhotic patients. The score ranges from 6 (least urgent) to 40 (gravely ill). The original formula is: MELD = 3.78 × ln(bilirubin) + 11.2 × ln(INR) + 9.57 × ln(creatinine) + 6.43, with MELD-Na = MELD + 1.32 × (137 − Na) − 0.033 × MELD × (137 − Na). Lab values below 1.0 are floored to 1.0 to avoid negative logarithms, and creatinine is capped at 4.0 mg/dL (or set to 4.0 if the patient has been on dialysis twice in the last 7 days).
This calculator is for adults aged 12 and older. For pediatric patients, the PELD (Pediatric End-Stage Liver Disease) score is used instead. Always consult your transplant center or hepatologist for official listing decisions, as exception points for conditions such as hepatocellular carcinoma (HCC) can modify your allocation priority.
About This Calculator
This MELD score calculator provides both the original MELD score and the updated MELD-Na score (2016 UNOS formula) along with the corresponding 3-month mortality estimate and clinical interpretation. The interactive chart displays your laboratory values in a bar chart, and a comparison view shows both scores side by side. The detailed breakdown table shows how each input contributes to your final score.
This tool is intended for educational and reference purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for medical decisions.
Frequently Asked Questions
What is the MELD score and how is it calculated?
The Model for End-Stage Liver Disease (MELD) score is a numerical scale from 6 to 40 used to prioritize adult patients for liver transplantation. It is calculated using serum bilirubin, creatinine, INR, and (since 2016) serum sodium using the formula: MELD = 3.78 × ln(bilirubin) + 11.2 × ln(INR) + 9.57 × ln(creatinine) + 6.43. If any value is below 1.0, it is set to 1.0; creatinine is capped at 4.0 mg/dL, and the final score is rounded to the nearest integer.
What is the difference between MELD and MELD-Na?
The MELD-Na score (introduced January 2016 by UNOS) incorporates serum sodium into the original MELD formula because hyponatremia is an independent predictor of mortality in end-stage liver disease. The MELD-Na formula is: MELD-Na = MELD + 1.32 × (137 − Na) − 0.033 × MELD × (137 − Na). Sodium is capped between 125 and 137 mEq/L. If MELD-Na is lower than the original MELD, the original MELD is used for transplant allocation.
What does my MELD score mean for transplant priority?
A higher MELD score indicates greater urgency for liver transplantation. Scores of 6-9 correspond to 1.9% 3-month mortality and low urgency. Scores of 10-19 indicate moderate severity with 6.0% mortality. Scores of 20-29 show high severity (19.6% mortality). Scores of 30-39 represent very high severity (52.6% mortality). A score of 40 is critical with 71.3% 3-month mortality. In the US, the median MELD at transplant is approximately 28-30.
What lab tests do I need to calculate my MELD score?
You need four blood test results: total bilirubin (mg/dL), which measures how well your liver excretes bile; serum creatinine (mg/dL), which assesses kidney function; INR (International Normalized Ratio), which measures blood clotting time; and serum sodium (mEq/L), which evaluates electrolyte balance. Additionally, you need to know if you have been on dialysis twice in the last 7 days, as this affects creatinine value calculation.
Who created the MELD score and when was it introduced?
The MELD score was developed by Dr. Patrick Kamath and colleagues at the Mayo Clinic, first published in Hepatology in February 2001. It was adopted by the United Network for Organ Sharing (UNOS) in 2002 to replace the Child-Pugh score for liver transplant allocation. The MELD-Na modification incorporating serum sodium was introduced in January 2016 and has been used by UNOS for organ allocation since then.
Can children use the MELD score?
No, the MELD score is validated for adult patients (age 12 and older) with end-stage liver disease. For pediatric patients under 12, the PELD (Pediatric End-Stage Liver Disease) score is used instead, which incorporates additional factors like growth failure and albumin levels. Always consult your transplant center for the appropriate scoring system for pediatric patients.
How often should the MELD score be recalculated?
MELD score is typically recalculated whenever clinical status changes. For patients on the transplant waiting list in the US, UNOS requires MELD score updates: every 7 days for patients with scores over 25, every 30 days for scores between 19-24, every 90 days for scores 11-18, and every year for scores of 10 or below. Always use the most recent lab values for accurate scoring.
What factors can affect my MELD score beyond the standard lab values?
Certain conditions can qualify for MELD exception points, including hepatocellular carcinoma (HCC) within Milan criteria, hepatopulmonary syndrome, portopulmonary hypertension, familial amyloid polyneuropathy, primary hyperoxaluria, and cystic fibrosis. These exceptions are reviewed by regional review boards. Additionally, patients with acute liver failure may qualify for Status 1 designation, which supersedes the MELD score.