MELD 3.0 Score Calculator
Calculate MELD 3.0 — the Model for End-Stage Liver Disease score that UNOS adopted in 2023 for prioritising liver-transplant candidates. MELD 3.0 builds on MELD-Na by adding female sex and serum albumin and re-fitting the coefficients, which raised scores for women who were previously disadvantaged. Enter bilirubin, INR, creatinine, sodium and albumin (conventional US units) and select sex.
The MELD 3.0 formula
MELD 3.0 = 1.33·(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. Bilirubin, INR and creatinine floored at 1.0; creatinine capped at 3.0; sodium bounded 125–137; albumin bounded 1.5–3.5. Source: Kim WR et al., Gastroenterology 2021;161(6):1887–1895; adopted by UNOS/OPTN in 2023.
Frequently asked questions
What is the MELD 3.0 formula?
MELD 3.0 = 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 are each floored at 1.0; creatinine is capped at 3.0; sodium is bounded 125–137 mmol/L; and albumin is bounded 1.5–3.5 g/dL. The rounded result is then held to the reported range of 6 to 40, so this calculator never returns a value outside those limits. Because the input floors are applied before the logarithms, a bilirubin, INR or creatinine entered below 1.0 is treated as 1.0 and contributes nothing to its own term, since ln(1) is zero.
How is MELD 3.0 different from MELD-Na?
MELD 3.0 adds two things the older MELD-Na left out: female sex (worth 1.33 points) and serum albumin, and it re-estimates every coefficient with interaction terms between sodium and bilirubin and between albumin and creatinine. It also lowers the creatinine cap from 4.0 to 3.0 mg/dL. The changes improved accuracy and, importantly, corrected a bias that had given women systematically lower scores and worse access to transplant.
Why does sex change the score?
At the same laboratory values, women tend to have lower creatinine because of smaller muscle mass, which made MELD-Na underestimate their illness. MELD 3.0 adds a fixed 1.33 points for female sex to compensate, so a woman and a man with otherwise identical labs receive scores 1.33 points apart before rounding. This was one of the main motivations for the update.
What does the dialysis option do?
In MELD 3.0, if the patient had haemodialysis at least twice in the past week, or 24 hours of continuous veno-venous haemodialysis (CVVHD), the creatinine used in the formula is set to the 3.0 mg/dL cap. As in earlier MELD versions, this prevents dialysis from masking the true severity of kidney dysfunction. Tick the box to apply it.
Is MELD 3.0 the current transplant score?
MELD 3.0 is the current adult liver-transplant allocation score in the United States, where it replaced MELD-Na in 2023. Scores are reported from 6 to 40, and higher means greater short-term mortality and higher priority. Actual allocation depends on the transplant centre and current policy; treat this as an educational reference, not a clinical or allocation tool.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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