MELD & MELD-Na Score Calculator
Calculate the MELD and MELD-Na scores — the Model for End-Stage Liver Disease used to rank the severity of chronic liver disease and to prioritise liver transplant candidates. This tool uses the UNOS/OPTN 2016 formula, which adds serum sodium to the original MELD. Enter bilirubin, INR, creatinine and sodium; values are in conventional (US) units.
How this is calculated
Equation. Base MELD = 10 × [0.957·ln(Cr) + 0.378·ln(Bili) + 1.120·ln(INR) + 0.643], rounded to a whole number. When Base MELD > 11: MELD-Na = MELD + 1.32·(137 − Na) − 0.033·MELD·(137 − Na).
| Term | Meaning |
|---|---|
| Cr | serum creatinine, mg/dL — floored at 1.0, capped at 4.0 (set to 4.0 if on dialysis) |
| Bili | total bilirubin, mg/dL — floored at 1.0 |
| INR | international normalised ratio — floored at 1.0 |
| Na | serum sodium, mmol/L — clamped 125–137 (added only when Base MELD > 11) |
| ln | natural logarithm |
The reported score is held to 6–40; higher is worse. Estimated 90-day mortality rises from ≈ 2% below 9 to ≈ 6% at 10–19, ≈ 20% at 20–29, and ≈ 70% at 40. MELD ≥ 15 is a common threshold for transplant benefit. Source: OPTN policy, effective January 2016.
Frequently asked questions
What is the MELD-Na formula?
First the base MELD is computed: MELD = 10 × [0.957 × ln(creatinine) + 0.378 × ln(bilirubin) + 1.120 × ln(INR) + 0.643], rounded to a whole number, with creatinine, bilirubin and INR each set to a minimum of 1.0 and creatinine capped at 4.0. If that score is above 11, sodium is added: MELD-Na = MELD + 1.32 × (137 − Na) − [0.033 × MELD × (137 − Na)], with sodium clamped between 125 and 137 mmol/L. The final score is reported from 6 to 40.
What is a good or bad MELD score?
A higher MELD score is worse. In the original validation the estimated 90-day mortality rose steeply with the score: roughly 2% below 9, about 6% at 10–19, around 20% at 20–29, over 50% at 30–39, and about 70% at 40. A MELD of 15 or above is often the point at which transplant benefit begins to outweigh the risks, and centres commonly refer patients from a score of about 10.
What does the dialysis option do?
In MELD, 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 automatically set to 4.0 mg/dL. This reflects that dialysis masks the true severity of kidney dysfunction. Tick the box to apply this rule.
How do I enter values measured in SI units?
This calculator uses conventional US units. To convert: creatinine µmol/L ÷ 88.4 = mg/dL; bilirubin µmol/L ÷ 17.1 = mg/dL. INR and sodium (mmol/L) are already the same in both systems. Enter the converted mg/dL figures for creatinine and bilirubin.
Is this the current transplant score?
MELD-Na (in use since January 2016) is still widely used and taught, but in 2023 UNOS adopted MELD 3.0, which additionally includes sex and serum albumin and adjusts the coefficients. For actual allocation decisions the transplant centre uses the version and policy in force. 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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