π« MELD Score Calculator
The liver allocation score, with MELD-Na.
For informational purposes only, not medical advice. Consult a healthcare professional.
The Model for End-Stage Liver Disease (MELD) predicts 90-day mortality in liver disease from three labs: bilirubin, INR, and creatinine. Scores run 6 to 40, and in the US the score prioritizes the liver transplant waitlist: sicker first, objectively. MELD-Na adds serum sodium, since hyponatremia independently predicts death in cirrhosis.
Enter the three labs plus sodium and dialysis status. The calculator applies the official UNOS formula rules (values below 1 set to 1, creatinine capped at 4.0, dialysis counts as 4.0) and returns both MELD and MELD-Na with the mortality estimate.
How to Use This Calculator
Use recent labs: total bilirubin in mg/dL, INR, creatinine in mg/dL, and sodium in mEq/L. Mark dialysis if dialyzed in the past week. Read MELD and MELD-Na on the 6 to 40 scale. Transplant centers use the official computed score; this calculator reproduces the same math for understanding and tracking.
Enter bilirubin, INR, creatinine, and sodium from recent labs.
Mark dialysis in the past week if applicable.
Read MELD and MELD-Na (6-40 scale).
Track the trend over time with your hepatology team.
The MELD Formula
MELD-Na = MELD + 1.32 x (137 - Na) - 0.033 x MELD x (137 - Na)
MELD began as a TIPS-procedure risk model (Malinchoc 2000) and proved so good at predicting short-term mortality that UNOS adopted it for liver allocation in 2002, replacing waiting time. The log transforms reflect that risk rises steeply at first then flattens: going from creatinine 1 to 2 matters more than 3 to 4. The floors (any value under 1 becomes 1) and the creatinine cap keep extreme values from distorting allocation. MELD-Na, adopted in 2016, adds up to about 13 points for severe hyponatremia because low sodium marks advanced circulatory dysfunction in cirrhosis. Values are rounded to integers and bounded 6 to 40.
Worked Example
Bilirubin 2.5, INR 1.4, creatinine 1.3, sodium 138: 16 (MELD-Na 16), carrying ~~6-20% 90-day mortality without transplant. Drop the sodium to 128 and MELD-Na climbs about 3 points, which is exactly why the sodium variant was adopted: hyponatremia independently predicts death in cirrhosis.
Reading the Score
MELD 6 to 9 carries roughly 2% 90-day mortality; 10 to 19 roughly 6 to 20%; 20 to 29 roughly 20 to 50%; 30 to 40 exceeds 50%. On the waitlist, higher scores get offered organs first, which is why the score is recalculated with every new lab set. MELD-Na usually runs a few points higher than MELD when sodium is low. The score predicts death from liver disease specifically; it does not capture frailty, infections, or liver cancer, which is why exception points exist for HCC.
Your Transplant Center Computes the Official Score
Listing decisions, exception points, and organ offers use the center's official calculation on certified labs. Use this calculator to understand and track your number between visits, not to dispute listing decisions. Worsening jaundice, confusion, bleeding, or swelling need prompt hepatology contact regardless of the score. For informational purposes only, not medical advice. Consult a healthcare professional.
Related tools: Lille score (alcoholic hepatitis), INR calculator and NAFLD fibrosis score.
For informational purposes only, not medical advice. Consult a healthcare professional.
Frequently Asked Questions
What is a good MELD score?
Lower is better: 6 is the minimum. Scores under 10 carry low short-term mortality; transplant listing is typically discussed at 15 and above.
What is the difference between MELD and MELD-Na?
MELD-Na adds serum sodium to the formula. Low sodium independently predicts death in cirrhosis, so MELD-Na prioritizes those patients higher.
What MELD score needs a liver transplant?
There is no fixed cutoff, but evaluation is commonly discussed at MELD 15+, since transplant benefit clearly exceeds risk above that range.
How often is MELD recalculated?
With every new lab draw on the waitlist; sicker patients update more often. Allocation always uses the most recent certified score.
Why is creatinine capped at 4.0?
To keep extreme kidney values from dominating allocation, and dialysis automatically counts as 4.0 since the measured value no longer reflects kidney function.
Can MELD go down?
Yes. Treating the underlying cause, stopping alcohol, or resolving an acute insult can improve labs and lower the score.
What are MELD exception points?
Extra priority for conditions the score underestimates, like hepatocellular carcinoma or portopulmonary hypertension, granted by review boards.
Does MELD predict survival after transplant?
No, it predicts death without transplant. Post-transplant outcomes depend on donor, surgical, and recipient factors beyond the score.
Why does MELD cap creatinine at 4.0?
Without the cap, a patient in acute kidney failure could rack up a MELD that overstates their liver disease and jumps the transplant queue unfairly. The cap keeps the score focused on liver-related risk. Dialysis patients are assigned 4.0 automatically, reflecting that their kidneys have effectively failed regardless of the lab number.
How often is MELD recalculated on the waitlist?
Transplant centers update it on a set schedule tied to the score: high MELD patients get retested every few days, lower scores weekly to monthly. The system needs fresh labs because MELD moves fast when patients deteriorate. If your labs worsen between draws, tell your transplant team; waiting for the next scheduled draw can cost you priority.