MELD Score Calculator: MELD 3.0, MELD-Na and Original MELD
Calculate the MELD 3.0 score used for US liver-transplant allocation since July 2023 (OPTN), plus MELD-Na and the original MELD, from bilirubin, INR, creatinine, sodium, albumin, sex and dialysis — with lab bounds applied, estimated 90-day survival, mortality bands and a term-by-term breakdown.
How it works
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, max 40 · bounds: bilirubin, INR, creatinine ≥ 1.0; creatinine ≤ 3.0 (3.0 on dialysis); Na 125–137; albumin 1.5–3.5 · 90-day survival = 0.946^exp(0.17698 × MELD 3.0 − 3.56) · MELD(i) = 10 × (0.957·ln(creatinine) + 0.378·ln(bilirubin) + 1.120·ln(INR) + 0.643), creatinine ≤ 4.0 (4.0 on dialysis) · MELD-Na = MELD(i) + 1.32·(137 − Na) − 0.033·MELD(i)·(137 − Na) when MELD(i) > 11
MELD (Model for End-stage Liver Disease) turns routine labs into one number that predicts short-term mortality in chronic liver disease and ranks adults and adolescents on the US liver-transplant waiting list. The original score (2002) used bilirubin, INR and creatinine; MELD-Na (2016) added serum sodium, because low sodium independently predicts death on the waiting list; and MELD 3.0, adopted by the OPTN in July 2023, adds albumin and a 1.33-point adjustment for female patients — whose lower muscle mass makes creatinine understate kidney dysfunction — lowers the creatinine cap to 3.0 mg/dL and includes two interaction terms. The logarithms give each lab diminishing weight as it rises; values below 1.0 are set to 1.0, sodium and albumin are held within fixed bounds, and dialysis sets creatinine to the cap. This calculator applies those rules, shows the score for the version you pick plus the other two, estimates 90-day survival with the MELD 3.0 survival function, places the score in the classic mortality bands (Wiesner 2003) and lists each term’s contribution, so you can see what drives the number. Bilirubin and creatinine can be entered in mg/dL or µmol/L and albumin in g/dL or g/L.
Worked example
With bilirubin 1.9 mg/dL, INR 1.2, creatinine 1.3 mg/dL, sodium 137 and albumin 3.5 in a man: MELD 3.0 = 4.56·ln(1.9) + 9.09·ln(1.2) + 11.14·ln(1.3) + 6 = 2.93 + 1.66 + 2.92 + 6 = 13.51, rounded to 14, with an estimated 90-day survival of 98.1%. The original MELD is 10 × (0.957·ln 1.3 + 0.378·ln 1.9 + 1.12·ln 1.2 + 0.643) = 13.4, rounded to 13, and MELD-Na is also 13 because sodium is 137. In the MELD 3.0 paper’s own example, a man with bilirubin 6.0, sodium 131, INR 1.5, creatinine 1.5 and albumin 3.5 scores 25; lowering albumin to 2.2 raises it to 26, with an estimated 90-day mortality of 14.5%.
Sources: Kim WR et al. (2021) — MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era, Gastroenterology 161:1887–1895 · Kim WR et al. (2008) — Hyponatremia and mortality among patients on the liver-transplant waiting list (MELD-Na), N Engl J Med 359:1018–1026 · Wiesner R et al. (2003) — Model for end-stage liver disease (MELD) and allocation of donor livers, Gastroenterology 124:91–96 · Kamath PS et al., Hepatology 2001 — MELD · OPTN — Liver and intestine policies (MELD 3.0, July 2023)
Frequently asked questions
Which MELD version is used for transplant listing now?
In the United States, MELD 3.0 has been used for liver allocation since July 2023, replacing MELD-Na (used from 2016) and the original MELD (from 2002). Other countries and many studies still report MELD or MELD-Na, so all three are shown.
Why are the labs floored at 1.0?
The natural log of a value below 1 is negative, which would wrongly pull the score down. Setting any lab under 1.0 to exactly 1.0 keeps that term at zero and stabilises the score.
Why is creatinine capped, and what happens on dialysis?
Very high creatinine from kidney failure would otherwise dominate the score. MELD 3.0 caps it at 3.0 mg/dL and MELD-Na and the original MELD at 4.0; a patient dialysed twice or more in the past week, or on continuous dialysis (CVVHD) for 24 hours, is scored at the cap.
Why does MELD 3.0 add points for women?
Women tend to have less muscle and therefore lower creatinine at the same kidney function, so creatinine-based scores underestimated their severity and they were less likely to receive a transplant. The 1.33-point term and the lower creatinine cap reduce that gap.
What MELD score is considered high?
In the original validation, 3-month mortality was about 1.9% below 10, 6% for 10–19, 19.6% for 20–29, 52.6% for 30–39 and 71.3% at 40. Transplant-centre referral is generally advised from about 15, the point where transplant starts to improve survival on average.
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Educational clinical estimate only — not a diagnosis, medical advice, or treatment. Scores are screening aids that must be interpreted by a qualified clinician alongside the full clinical picture. Never make care decisions from this tool alone.