MELD Score Calculator – Model for End-Stage Liver Disease
Calculate MELD score for liver disease severity and transplant priority
How to Use
- Enter serum bilirubin level in mg/dL
- Enter INR (International Normalized Ratio) value
- Enter serum creatinine level in mg/dL
- Click calculate to see your MELD score and mortality risk
What is the MELD Score?
The MELD (Model for End-Stage Liver Disease) score is a numerical scale used to assess the severity of chronic liver disease and predict short-term mortality. It was originally developed to predict survival in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) procedures but is now primarily used to prioritize patients for liver transplantation.
The score ranges from 6 (less ill) to 40 (gravely ill) and is calculated using three laboratory values: serum bilirubin, serum creatinine, and INR (international normalized ratio for prothrombin time).
MELD Score Formula
The MELD score is calculated using the following formula:
MELD = 3.78×ln(bilirubin mg/dL) + 11.2×ln(INR) + 9.57×ln(creatinine mg/dL) + 6.43
For the calculation, all laboratory values are capped at a minimum of 1.0. The final score is rounded to the nearest whole number and ranges from 6 to 40.
MELD Score and Mortality Risk
| MELD Score | Severity | 3-Month Mortality |
|---|---|---|
| < 10 | Low Risk | ~2% |
| 10-19 | Moderate Risk | ~6% |
| 20-29 | High Risk | ~20% |
| 30-40 | Very High Risk | >50% |
MELD Score in Liver Transplant Allocation
In the United States and many other countries, the MELD score is the primary criterion for allocating liver transplants to adult patients with end-stage liver disease. Patients with higher MELD scores have priority for transplantation because they have the greatest risk of death while waiting.
- MELD scores are updated regularly as lab values change
- Exception points may be added for certain conditions not reflected in the score
- Minimum MELD score for listing varies by region and organ availability
- MELD-Na (including sodium) is used in some systems for improved accuracy
Limitations of MELD Score
While the MELD score is a valuable tool, it has several limitations:
- Does not capture all complications of liver disease (ascites, encephalopathy, variceal bleeding)
- May underestimate disease severity in patients with hepatocellular carcinoma
- Not validated for acute liver failure
- May be affected by renal replacement therapy
- Does not account for quality of life or functional status
Frequently Asked Questions
- What is a normal MELD score?
- A normal MELD score is 6-9, which indicates minimal liver dysfunction. Scores of 10 or higher indicate increasing severity of liver disease and higher mortality risk.
- How often should MELD scores be calculated?
- For patients on the liver transplant waiting list, MELD scores are typically recalculated every 3 months or more frequently if the patient's condition changes. Your healthcare team will determine the appropriate frequency.
- Can MELD scores improve over time?
- Yes, MELD scores can improve if liver function improves through treatment, lifestyle changes, or resolution of acute complications. Conversely, scores can worsen with disease progression.
- What MELD score qualifies for liver transplant?
- Minimum MELD scores for transplant listing vary by transplant center and region, but generally range from 10-15. Higher scores receive higher priority for available organs. Your transplant center can provide specific criteria.