MELD / MELD-Na Score Calculator

Calculate the Model for End-Stage Liver Disease (MELD) score to predict 3-month mortality and prioritize liver transplant allocation. MELD-Na incorporates serum sodium for improved accuracy.

Enter Values

Total Bilirubin (mg/dL)

Normal: 0.2–1.2 mg/dL (values <1 are set to 1)

Serum Creatinine (mg/dL)

Normal: 0.7–1.3 mg/dL (capped at 4.0; set to 4.0 if on dialysis)

INR

Normal: 0.8–1.2 (values <1 are set to 1)

Serum Sodium (mEq/L)

Normal: 136–145 mEq/L (constrained to 125–137 in formula)

On Dialysis (≥2x/week)

Sets creatinine to 4.0 mg/dL

MELD-Na Formula:

MELD = 3.78×ln(Bil) + 11.2×ln(INR) + 9.57×ln(Cr) + 6.43

MELD-Na = MELD + 1.32×(137−Na) − 0.033×MELD×(137−Na)

Enter Bilirubin, Creatinine, and INR to calculate the MELD score

Add Sodium for MELD-Na calculation

Mortality Risk Stratification

≤9

10–19

20–29

30–39

MELD Range	3-Month Mortality	Transplant Priority
≤ 9	1.9%	Low transplant priority
10–19	6.0%	Moderate transplant priority
20–29	19.6%	High transplant priority
30–39	52.6%	Very high transplant priority
≥ 40	71.3%	Highest transplant urgency (Status 1)

Clinical Context

MELD vs MELD-Na

MELD-Na adds serum sodium to improve accuracy. Hyponatremia (Na <135) is common in cirrhosis and independently predicts mortality. MELD-Na is now the standard for transplant allocation in most centers.

When to Use MELD

Primary use: liver transplant allocation priority. Also used to assess prognosis in cirrhosis, predict post-TIPS survival, guide timing of transplant listing, and evaluate surgical risk in patients with liver disease.

Limitations & Exceptions

Does not capture all factors affecting prognosis (e.g., HCC, hepatopulmonary syndrome). Exception points may be granted for conditions poorly reflected by MELD (HCC within Milan criteria, portopulmonary hypertension). INR varies between labs — may affect score consistency.

MELD >15: Transplant Benefit

Studies show transplant survival benefit begins at MELD ≥15. Below this threshold, transplant risk may exceed disease risk. MELD ≥35 may indicate futility in some cases — multidisciplinary assessment essential.