MELD Score Calculator

The MELD (Model for End-Stage Liver Disease) score is a numerical scale used to assess the severity of chronic liver disease. It is primarily used by UNOS/OPTN to prioritize patients on the liver transplant waiting list based on their risk of dying within 90 days without a transplant. Higher scores indicate more severe disease and greater urgency.

This calculator uses the updated MELD 3.0 formula (effective July 13, 2023): MELD 3.0 = 4.56 × ln(bilirubin) + 0.82 × (137 − sodium) − 0.24 × (137 − sodium) × ln(creatinine) + 9.09 × ln(INR) + 11.14 × ln(creatinine) + 1.85 × (3.5 − albumin) − 1.83 × (3.5 − albumin) × ln(creatinine) + sex coefficient + 7. The final score is rounded to the nearest integer and capped between 6 and 40.

Patients on dialysis (at least twice in the past week or on 24-hour continuous veno-venous hemodialysis) have their serum creatinine automatically set to 3.0 mg/dL per OPTN guidelines. This is because dialysis artificially lowers serum creatinine, which would otherwise underestimate the severity of renal failure in these patients.

A MELD score below 10 indicates mild disease with low short-term mortality. Scores of 10–19 reflect moderate disease. Scores of 20–29 indicate significant liver failure. Scores of 30–39 represent severe disease with high mortality risk. A score of 40 is the maximum and carries the highest urgency for transplantation.

Serum sodium is incorporated into the MELD 3.0 formula because hyponatremia (low sodium) is associated with worse outcomes in liver disease patients beyond what creatinine, bilirubin, and INR capture alone. Values below 125 mEq/L are capped at 125 and values above 137 mEq/L are capped at 137 in the calculation.

Sex was added to the MELD 3.0 formula (effective 2023) after research showed that female patients had higher waitlist mortality at equivalent MELD scores compared to male patients. Including sex helps reduce this disparity and improves the accuracy of mortality prediction across all patients.

The MELD calculator is recommended for patients aged 12 and older. Children under 12 are evaluated using the PELD (Pediatric End-Stage Liver Disease) score, which uses different variables better suited to pediatric liver disease assessment.

MELD scores are recalculated at regular intervals depending on the score value. Patients with higher scores (indicating more urgent need) are recalculated more frequently — as often as every 7 days for scores of 25 or above — to ensure the waiting list accurately reflects current medical urgency.