MELD Calculator
Model for End-Stage Liver Disease - Assess transplant priority and 90-day mortality risk
Calculate MELD Score
Formula Selection
The MELD-Na formula is the current standard used by transplant centers worldwide
Laboratory Values
Normal: 0.6-1.3 mg/dL (53-115 μmol/L). Minimum value used: 1.0 mg/dL
Normal: 0.3-1.2 mg/dL (5-21 μmol/L). Minimum value used: 1.0 mg/dL
Normal: 1.0-1.5. Minimum value used: 1.0
Normal: 135-145 mEq/L. Capped between 125-137 mEq/L for calculation
Dialysis Status
If checked, creatinine will be automatically set to 4.0 mg/dL for calculation
MELD Score Results
Clinical Interpretation
Transplant Priority: Consider transplant evaluation if progressive
90-day Mortality Risk: 6% based on historical data
Values Used in Calculation
Values are automatically adjusted to minimum thresholds required by MELD formula
Formula Used
MELD = 10 × [(0.957 × ln(1.00)) + (0.378 × ln(1.00)) + (1.12 × ln(1.00))] + 6.43 = 6
MELD-Na = 6 + 1.32 × (137 - 125) - 0.033 × 6 × (137 - 125)
MELD-Na Score = 19
⚠️ Critical Medical Information
The MELD score is used for liver transplant prioritization and should only be interpreted by qualified healthcare professionals. This calculator is not suitable for children under 12 years old.
Important: MELD scores are used alongside clinical judgment, blood type compatibility, geographic location, and other factors in transplant allocation decisions.
Example Calculation
Patient with End-Stage Liver Disease
Creatinine: 2.1 mg/dL
Bilirubin: 4.2 mg/dL
INR: 2.8
Sodium: 132 mEq/L
Dialysis: No
Calculation
Original MELD: 10 × [(0.957×ln(2.1)) + (0.378×ln(4.2)) + (1.12×ln(2.8))] + 6.43 = 25
MELD-Na: 25 + 1.32×(137-132) - 0.033×25×(137-132) = 27
Interpretation: High risk - 19.6% 90-day mortality, should be evaluated for transplant
MELD Score Ranges
40: Critical (71.3%)
Immediate transplant needed
30-39: Very High (52.6%)
Urgent transplant priority
20-29: High (19.6%)
Moderate transplant priority
10-19: Moderate (6.0%)
Low-moderate priority
≤9: Low (1.9%)
Continue monitoring
Required Laboratory Tests
- •Serum Creatinine: Kidney function indicator
- •Total Bilirubin: Liver function marker
- •INR: Blood clotting assessment
- •Serum Sodium: Electrolyte balance (MELD-Na only)
Normal Laboratory Values
Understanding the MELD Score
What is MELD?
The Model for End-Stage Liver Disease (MELD) is a scoring system used to prioritize patients for liver transplantation. It predicts 90-day mortality and helps ensure the sickest patients receive transplants first.
Clinical Applications
- •Liver transplant prioritization
- •90-day mortality prediction
- •Treatment planning and prognosis
- •Resource allocation decisions
MELD vs MELD-Na
Original MELD (Pre-2016):
10 × [(0.957 × ln(creatinine)) + (0.378 × ln(bilirubin)) + (1.12 × ln(INR))] + 6.43
MELD-Na (2016-Current):
MELD + 1.32 × (137 - sodium) - 0.033 × MELD × (137 - sodium)
The MELD-Na formula includes serum sodium, which improves prediction accuracy for patients with low sodium levels (hyponatremia).
End-Stage Liver Disease
End-stage liver disease represents the final stage of chronic liver disease where the liver can no longer function adequately to sustain life without transplantation.
Common Causes
- • Hepatitis B and C infection
- • Alcoholic liver disease
- • Non-alcoholic fatty liver disease (NAFLD)
- • Primary biliary cholangitis
- • Autoimmune hepatitis
- • Hemochromatosis
Clinical Features
- • Jaundice (elevated bilirubin)
- • Ascites (fluid retention)
- • Hepatic encephalopathy
- • Coagulopathy (bleeding tendency)
- • Portal hypertension
- • Renal dysfunction
Transplant Allocation
MELD scores are used in conjunction with other factors for transplant allocation:
Medical Factors
- • MELD score
- • Blood type compatibility
- • Organ size match
- • Time on waiting list
- • Geographic location
Special Situations
- • Hepatocellular carcinoma
- • Metabolic disorders
- • Fulminant hepatic failure
- • Status 1A patients
- • Living donor availability
Contraindications
- • Active alcohol/drug use
- • Severe cardiac disease
- • Advanced malignancy
- • Uncontrolled infection
- • Psychiatric instability