About the MELD Score Calculator
The Model for End-Stage Liver Disease (MELD) score measures how severe chronic liver disease is and predicts 90-day mortality. In the United States it has been used to prioritise adults on the liver transplant waiting list since 2002. The original MELD uses bilirubin, creatinine and INR; MELD-Na (2016) added serum sodium; and MELD 3.0, adopted by the Organ Procurement and Transplantation Network (OPTN) in July 2023, adds sex and serum albumin and caps creatinine at 3.0 mg/dL.
This calculator shows all three side by side so hepatologists, transplant coordinators, trainees and patients can compare them and understand a score quoted in clinic. Enter labs in US units (mg/dL, g/dL) or SI units (µmol/L, g/L). The OPTN rules are applied: lab values below 1.0 are set to 1.0, sodium is bounded to 125–137 mmol/L, albumin to 1.5–3.5 g/dL, and creatinine is capped (4.0 mg/dL for MELD and MELD-Na, 3.0 for MELD 3.0) or set to the cap for patients on dialysis.
MELD applies to adults and adolescents aged 12 and over; children under 12 use the PELD score. Exception points for conditions such as hepatocellular carcinoma are assigned separately by transplant review and are not reflected here.
With the default inputs, the meld 3.0 (current optn score) is 20. Change any value above to recalculate instantly.
How to use the meld score calculator
- 1Choose US or SI lab units.
- 2Enter total bilirubin, creatinine, INR and sodium from the same day’s blood tests.
- 3Enter albumin and sex for MELD 3.0.
- 4Tick dialysis if the patient had two or more sessions, or 24 hours of CVVHD, in the past week.
- 5Read MELD 3.0 alongside MELD-Na and the original MELD.
Formula and method
All three versions use natural logarithms of bilirubin, creatinine and INR (US units), with any value below 1.0 set to 1.0. For MELD and MELD-Na creatinine is capped at 4.0 mg/dL, and set to 4.0 if the patient had dialysis at least twice or 24 hours of CVVHD in the prior week. MELD(i) is rounded to one decimal and multiplied by 10; if it exceeds 11 the sodium term is added, with sodium bounded to 125–137 mmol/L, and the result is rounded. This is the OPTN form of MELD-Na (2016–2023) as restated by Kim et al. in the MELD 3.0 paper; the 2008 research version bounded sodium at 140 with different coefficients.
MELD 3.0 (Kim et al., 2021) adds 1.33 points for female sex, includes albumin bounded to 1.5–3.5 g/dL, models interactions between bilirubin and sodium and between albumin and creatinine, and caps creatinine at 3.0 mg/dL (3.0 on dialysis). Scores are rounded to whole numbers and reported in the OPTN range of 6 to 40.
- Bili
- Total bilirubin, mg/dL (µmol/L ÷ 17.1)
- Cr
- Serum creatinine, mg/dL (µmol/L ÷ 88.4)
- INR
- International normalised ratio
- Na
- Serum sodium, mmol/L (bounded 125–137)
- Alb
- Serum albumin, g/dL (g/L ÷ 10; bounded 1.5–3.5)
Worked examples
Cirrhosis with mild hyponatraemia
With bilirubin 2.5, creatinine 1.2, INR 1.6, sodium 132 and albumin 2.9 in a man, MELD(i) is 0.957·ln 1.2 + 0.378·ln 2.5 + 1.12·ln 1.6 + 0.643 = 1.69, which rounds to 1.7 and becomes 17. Sodium 5 below 137 raises MELD-Na to 17 + 6.6 − 2.8 ≈ 21, while MELD 3.0 gives 20.
Woman on dialysis, SI units
Bilirubin 120 µmol/L is 7.02 mg/dL and albumin 25 g/L is 2.5 g/dL. Dialysis sets creatinine to 4.0 for MELD (35) and MELD-Na (36), and to 3.0 for MELD 3.0, which with the female-sex point and low albumin reaches 38.
Well-compensated disease
Creatinine below 1.0 is set to 1.0, sodium above 137 is set to 137 and albumin above 3.5 to 3.5. MELD(i) is 8, so no sodium correction applies and MELD-Na is also 8; MELD 3.0 gives 7 — mild disease.
Frequently asked questions
What is a normal MELD score?+
The lowest possible score is 6, seen in people with essentially normal bilirubin, creatinine and INR. Scores rise with disease severity to a maximum of 40 used for allocation.
What MELD score is needed for a liver transplant?+
There is no single threshold. Patients are generally referred for evaluation at a MELD of about 15 or higher, and the score needed to receive an offer varies by region and blood type.
What is the difference between MELD-Na and MELD 3.0?+
MELD 3.0 keeps bilirubin, creatinine, INR and sodium but adds female sex and albumin, adds interaction terms, and caps creatinine at 3.0 instead of 4.0 mg/dL. It was designed to reduce the disadvantage women faced under MELD-Na.
Which MELD score does OPTN use now?+
Since July 2023, OPTN has used MELD 3.0 for adult liver allocation in the US. MELD-Na and the original MELD are still common in research, other countries and older records.
Why is creatinine set to 4.0 on dialysis?+
Dialysis artificially lowers creatinine, which would understate kidney failure and liver disease severity. The rule assigns the maximum creatinine so dialysis patients are not disadvantaged.
Can MELD be used for children?+
MELD is used from age 12. Children under 12 are scored with PELD (Pediatric End-Stage Liver Disease), which uses different variables including growth and age.
For healthcare professionals and education only. This calculator implements a published formula or score but is not a diagnosis and does not replace clinical judgment. Verify inputs and results against the original source before using them in patient care.
Sources
- Kim WR et al. MELD 3.0: The Model for End-Stage Liver Disease updated for the modern era. Gastroenterology 2021
- Kim WR et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med 2008 (original MELDNa; OPTN later adopted the 137-bounded form quoted in Kim 2021)
- Kamath PS et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001