What is the MELD score used for?

The MELD score quantifies 90-day mortality risk in patients with end-stage liver disease from any cause. Since 2002, UNOS/OPTN has used it to prioritize patients on the liver transplant waiting list — the sicker the patient (higher score), the higher the priority for a donor organ. It replaced the Child-Pugh score for transplant allocation because it is more objective and better calibrated to short-term mortality.

What is the difference between MELD and MELD-Na?

Classic MELD uses bilirubin, creatinine, and INR. MELD-Na adds serum sodium, which is an independent predictor of mortality in cirrhosis. Hyponatremia (low sodium) worsens outcomes beyond what the classic MELD captures. UNOS adopted MELD-Na as the official allocation score in January 2016. This calculator computes both for comparison.

Why is creatinine capped at 4.0 mg/dL?

The MELD formula uses a natural log of creatinine. Very high creatinine values (e.g., in patients on dialysis) would dominate the score disproportionately. UNOS guidelines cap creatinine at 4.0 mg/dL and assign a minimum of 1.0 mg/dL to avoid a negative log. Patients on hemodialysis are automatically assigned a creatinine of 4.0 mg/dL.

What MELD score is needed for a liver transplant?

There is no fixed cutoff — allocation is based on relative priority among patients in the same blood type and region. In practice, patients with MELD scores below 15 often have better survival without transplant than with it. Scores above 15 generally favor transplantation. Scores above 25 indicate high urgency; scores of 40 carry roughly 71% 90-day mortality without transplant.

Can MELD be used for alcoholic hepatitis or acute liver failure?

MELD was originally developed and validated for chronic liver disease with portal hypertension. It is also used in alcoholic hepatitis to predict short-term mortality, but the Maddrey Discriminant Function and ABIC score are additional tools for that context. For acute liver failure (e.g., acetaminophen toxicity), King's College Criteria are preferred. Always combine MELD with full clinical assessment.

Is this tool a substitute for clinical judgment?

No. This calculator is for educational and reference purposes only. MELD scores should be interpreted in the context of the full clinical picture, etiology, comorbidities, functional status, and local transplant center criteria. Transplant decisions involve multidisciplinary teams and are governed by national allocation policy. Never use this tool as the sole basis for any medical decision.

MELD Score Calculator

Name: MELD Score Calculator
Availability: InStock
Author: Nham Vu

Enter serum bilirubin, creatinine, INR, and sodium to calculate the MELD and MELD-Na scores for liver disease severity assessment.

Lab Values

Serum Bilirubin (mg/dL)

Minimum applied: 1.0 mg/dL per UNOS guidelines

Serum Creatinine (mg/dL)

Capped at 4.0 mg/dL; dialysis patients enter 4.0

INR (International Normalized Ratio)

Minimum applied: 1.0 per UNOS guidelines

Serum Sodium (mEq/L) — for MELD-Na

Clamped to 125–137 mEq/L in the formula

MELD Formula (UNOS)

MELD = 10 × (0.957 × ln(Cr) + 0.378 × ln(Bili) + 1.120 × ln(INR)) + 6.43
MELD-Na = MELD + 1.32×(137−Na) − [0.033×MELD×(137−Na)]

Enter lab values on the left and click Calculate MELD Score

MELD Score

—

Classic (bilirubin, Cr, INR)

MELD-Na Score

—

UNOS allocation (adds sodium)

Severity Category

—

610203040+

Calculation Breakdown

90-Day Mortality Reference (MELD)

MELD Range	Severity	~90-Day Mortality

Clinical note: This tool is for educational reference only. MELD scores guide transplant allocation policy and are not a substitute for full clinical evaluation, multidisciplinary hepatology review, or transplant center protocols. Mortality estimates are population-based approximations. Always confirm results with laboratory-reported values and clinical judgment.

Summary

Enter serum bilirubin, creatinine, INR, and sodium to calculate the MELD and MELD-Na scores for liver disease severity assessment.

How it works

Enter the most recent serum bilirubin (mg/dL) from lab results.
Enter the serum creatinine (mg/dL); values are capped at 4.0 per UNOS guidelines.
Enter the INR (International Normalized Ratio) from a coagulation panel.
Enter the serum sodium (mEq/L) for the MELD-Na calculation.
Click Calculate to compute both the classic MELD and the MELD-Na score.
Review the score, 90-day mortality estimate, and UNOS priority category.

Use cases

Estimate 90-day mortality risk in patients with cirrhosis or end-stage liver disease.
Assess transplant priority using the UNOS organ allocation formula.
Track disease progression over serial measurements during hospitalization.
Compare MELD versus MELD-Na to identify patients whose sodium improves mortality prediction.
Support clinical decision-making for ICU triage in acute-on-chronic liver failure.
Educate patients and families about liver disease severity using an objective score.
Screen candidates for portosystemic shunt procedures (TIPS) where MELD predicts post-procedure survival.
Aid hepatology documentation with a reproducible, guideline-referenced severity score.

Frequently Asked Questions

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Last updated: 2026-05-23 · Reviewed by Nham Vu