MELD Score Calculator (MELD 3.0, MELD-Na, MELD)

MELD score calculator: MELD 3.0, MELD-Na and the original MELD

For healthcare professionals and students. Check results against your local protocols and clinical judgement; this tool does not give medical advice.

This MELD score calculator gives the three versions of the Model for End-Stage Liver Disease side by side: MELD 3.0, used by the US Organ Procurement and Transplantation Network (OPTN) for liver allocation since July 2023; MELD-Na, used from January 2016 and still common in clinics and studies; and the original MELD. Enter bilirubin, INR, creatinine, sodium, albumin and sex, tick the dialysis box if it applies, and each score is computed with the OPTN floors, caps and rounding, with the working shown.

Labs can be entered in US units (mg/dL, g/dL) or SI units (µmol/L, g/L). The calculation runs in your browser.

How to use the MELD Score Calculator

1. Enter total bilirubin and creatinine, choosing mg/dL or µmol/L for each.
2. Enter the INR and the sodium in mmol/L (the same number as mEq/L).
3. Enter the albumin in g/dL or g/L and choose the sex.
4. Tick dialysis if the patient had dialysis at least twice in the week before the creatinine, or 24 hours of CVVHD.
5. Read MELD 3.0, MELD-Na and MELD, check the bound and unit warnings, and copy the summary if needed.

MELD Score Calculator features

MELD formulas and OPTN rules

Worked example from the OPTN Liver and Intestinal Organ Transplantation Committee (November 2013): creatinine 1.9 mg/dL, bilirubin 4.2 mg/dL and INR 1.2 give MELD(i) 2.0039, so MELD 20; with sodium 133 mmol/L, MELD-Na is 20 + 5.28 − 2.64 = 22.64, so 23 (27 at sodium 127, 21 at sodium 135). With albumin 3.0 g/dL, MELD 3.0 is 24 for a man and 25 for a woman (hand-calculated).

• MELD 3.0 (Kim WR, Mannalithara A, Heimbach JK, et al. Gastroenterology 2021;161(6):1887–1895): 1.33 (if female) + 4.56 ln(bilirubin) + 0.82 (137 − Na) − 0.24 (137 − Na) ln(bilirubin) + 9.09 ln(INR) + 11.14 ln(creatinine) + 1.85 (3.5 − albumin) − 1.83 (3.5 − albumin) ln(creatinine) + 6, rounded to a whole number. Bilirubin, INR and creatinine below 1.0 are set to 1.0; creatinine above 3.0, or after dialysis twice in 7 days or 24 hours of CVVHD, is set to 3.0; sodium is bounded 125–137 mmol/L and albumin 1.5–3.5 g/dL.
• Original MELD (Kamath PS et al. Hepatology 2001;33(2):464–470, as used by OPTN): MELD(i) = 0.957 ln(creatinine) + 0.378 ln(bilirubin) + 1.120 ln(INR) + 0.643, rounded to the tenth and multiplied by 10. Values below 1.0 are set to 1.0; creatinine is capped at 4.0 and set to 4.0 after dialysis.
• MELD-Na (Kim WR et al. N Engl J Med 2008;359:1018–1026, as adopted by OPTN): when MELD(i) is above 11, MELD = MELD(i) + 1.32 × (137 − Na) − 0.033 × MELD(i) × (137 − Na), with sodium bounded 125–137 mmol/L. All scores are limited to 40.

MELD score and mortality

Wiesner R, Edwards E, Freeman R, et al. Gastroenterology 2003;124(1):91–96 reported observed 3-month mortality by original MELD in 3,437 adults with chronic liver disease listed for transplant in the US between 1999 and 2001. These are population figures from that era, not a prediction for one patient, and they do not transfer directly to MELD-Na or MELD 3.0 values.

Why MELD 3.0 changed things

MELD 3.0 added albumin and sex, updated the coefficients, added interactions between sodium and bilirubin and between albumin and creatinine, and lowered the creatinine cap from 4.0 to 3.0 mg/dL. The female term partly corrects the disadvantage women had under MELD-Na, because the same creatinine reflects lower kidney function in people with less muscle mass. For kidney function itself, the eGFR calculator gives a creatinine-based estimate.