What is the MELD-Na score and how is it used for transplant?

MELD-Na is the official organ allocation score used by UNOS/OPTN in the United States since 2016. Patients with higher MELD-Na scores are sicker and receive higher priority for deceased-donor liver offers. The score replaced the original MELD because serum sodium independently predicts 90-day mortality in cirrhosis, especially in patients with dilutional hyponatremia.

What MELD-Na score is needed to be listed for a liver transplant?

Most transplant centers list patients when the MELD-Na reaches 15 or above, as transplant benefit (survival gain) typically outweighs surgical risk at that threshold. However, listing criteria vary by center and UNOS region. Some high-volume centers may list at lower scores if the patient is declining rapidly.

What are the regional and national sharing thresholds?

Under current UNOS policy, livers are first offered locally, then regionally. Regional sharing is triggered at MELD-Na ≥ 15 (varies by region). National sharing (Share 35) applies to patients with MELD-Na ≥ 35 — these patients receive priority over local recipients with lower scores, reflecting their critical short-term mortality risk.

How are creatinine values capped in the formula?

Per UNOS guidelines, creatinine is capped at 4.0 mg/dL. Patients who received dialysis two or more times in the past week are automatically assigned creatinine = 4.0. Values below 1.0 are set to 1.0 to prevent negative log contributions that would artificially deflate the score.

Why is sodium clamped between 125 and 137 mEq/L?

The UNOS MELD-Na formula clamps sodium to 125–137 mEq/L. Values below 125 are treated as 125, and values above 137 are treated as 137. This prevents extreme electrolyte values from producing implausibly high or low scores outside the validated range of the formula.

Is this calculator a substitute for clinical judgment?

No. This tool is for educational and informational purposes only. MELD-Na scores must always be interpreted by a qualified hepatologist or transplant specialist in the full clinical context. Organ allocation decisions are made by transplant teams and UNOS, not by calculators.

How often is MELD-Na recalculated for waitlisted patients?

UNOS requires periodic score updates for waitlisted patients: every 7 days for MELD-Na ≥ 25, every 30 days for scores 19–24, every 90 days for scores 11–18, and every year for scores ≤ 10. Frequent recalculation ensures the waitlist reflects the most current disease severity.

MELD-Na Transplant Score

Name: MELD-Na Transplant Score
Availability: InStock
Author: Nham Vu

Enter creatinine, bilirubin, INR, and sodium to compute the MELD-Na score and see how it maps to liver transplant waitlist priority under UNOS/OPTN policy.

Lab Values

Enter the patient's most recent lab results.

Serum Creatinine (mg/dL)

Capped at 4.0 per UNOS. Dialysis patients: enter 4.0.

Total Bilirubin (mg/dL)

INR (international normalized ratio)

Serum Sodium (mEq/L)

Values outside 125–137 are clamped per UNOS formula.

UNOS Organ Sharing Thresholds

MELD-Na	Allocation Level	90-Day Mortality
< 10	Local — low priority	< 2%
10–14	Local — standard	2–6%
15–24	Regional sharing eligible	6–20%
25–34	High regional priority	20–50%
≥ 35	Share 35 — national priority	> 50%

Allocation thresholds reflect UNOS/OPTN policy. Actual offers depend on blood type, organ size, cold ischemia time, and regional/national distribution rules. This tool is for educational use only — not a substitute for clinical or transplant team evaluation.

Summary