acalculator

What is my MELD score?

Enter bilirubin, INR, creatinine, sodium, and albumin, in US or SI units, to calculate the MELD 3.0 score, or pick MELD-Na or the original MELD. For information only. This is not medical advice or a diagnosis. Do not use it to make treatment decisions without a clinician. No licensed clinician has reviewed this page.

Your numbers

Lab units
Sex
Score
16

The MELD 3.0 score is 16.

Score used
MELD 3.0
Original MELD
12
MELD-Na
18

Score: 16. The MELD 3.0 score is 16.

Where does the score sit?

This calculator gives general information only. It is not medical advice and does not replace a doctor or other health care provider. Talk with a professional about your results. Terms of use

How to calculate

Calculates the MELD 3.0 score (Kim 2021), the MELD-Na score, or the original MELD score for adults with chronic liver disease, from bilirubin, INR, creatinine, sodium, and albumin in US or SI units.

Example with the default inputs (Score MELD 3.0, Lab units US, Sex Male, Bilirubin (mg/dL) 2.5, INR 1, Creatinine (mg/dL) 1.2, Dialysis twice or more in the past week No, Sodium (mmol/L) 131, Albumin (g/dL) 3.8): The MELD 3.0 score is 16.

Method: 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, rounded; MELD = 9.57 ln(creatinine) + 3.78 ln(bilirubin) + 11.20 ln(INR) + 6.43, rounded; MELD-Na = MELD + 1.32 (137 − Na) − 0.033 × MELD × (137 − Na) when MELD > 11, rounded.

  • Adults with chronic liver disease. Bilirubin in mg/dL, creatinine in mg/dL, albumin in g/dL, sodium in mmol/L.
  • Bilirubin, INR, and creatinine below 1.0 count as 1.0. Sodium counts between 125 and 137, albumin (MELD 3.0) between 1.5 and 3.5.
  • Creatinine counts at most 3.0 (MELD 3.0) or 4.0 (MELD, MELD-Na), and at that ceiling after dialysis twice or more in the past week.
  • SI values are converted with 1 mg/dL = 17.1 µmol/L (bilirubin), 88.4 µmol/L (creatinine), and 1 g/dL = 10 g/L (albumin).

Machine-readable copies: Markdown, JSON.

Worked examples

Each example is checked against the calculator on every build.

  1. Score MELD 3.0, Lab units US, Sex Male, Bilirubin (mg/dL) 2.5, INR 1, Creatinine (mg/dL) 1.2, Dialysis twice or more in the past week no, Sodium (mmol/L) 131, Albumin (g/dL) 3.8 gives Score 16, Original MELD 12, MELD-Na 18.Source: Kim et al., Gastroenterology 2021, Table 4 (low risk, male): MELD 12, MELDNa 18, MELD 3.0 16
  2. Score MELD 3.0, Lab units US, Sex Female, Bilirubin (mg/dL) 6, INR 1.5, Creatinine (mg/dL) 1.5, Dialysis twice or more in the past week no, Sodium (mmol/L) 131, Albumin (g/dL) 2.2 gives Score 27, Original MELD 22, MELD-Na 26.Source: Kim et al. 2021, Table 4 (intermediate risk, female, albumin 2.2): MELD 22, MELDNa 26, MELD 3.0 27
  3. Score MELD 3.0, Lab units SI, Sex Male, Bilirubin (µmol/L) 205.2, INR 2.2, Creatinine (µmol/L) 247.52, Dialysis twice or more in the past week no, Sodium (mmol/L) 128, Albumin (g/L) 20 gives Score 38, Original MELD 35, MELD-Na 36.Source: Kim et al. 2021, Table 4 (high risk, male, creatinine 2.8): MELD 35, MELDNa 36, MELD 3.0 38
  4. Score MELD-Na, Lab units US, Bilirubin (mg/dL) 12, INR 2.2, Creatinine (mg/dL) 1.8, Dialysis twice or more in the past week no, Sodium (mmol/L) 128 gives Score 33, Original MELD 30, MELD-Na 33.Source: Kim et al. 2021, Table 4 (high risk, creatinine 1.8): MELD 30, MELDNa 33
  5. Score MELD (original), Lab units US, Bilirubin (mg/dL) 0.8, INR 0.9, Creatinine (mg/dL) 5, Dialysis twice or more in the past week no gives Score 20, Original MELD 20.Source: Kim et al. 2021 MELD formula: bilirubin and INR below 1.0 are set to 1.0 and creatinine of 4 or more to 4.0

Medical disclaimer

This calculator is for information and education only. It is not medical advice, and its result is not a diagnosis. Do not use it to start, stop, or change a treatment without a clinician who knows your health history. No licensed clinician has reviewed this page. This site's editors checked the formulas and worked examples against published sources. If you think you have a medical emergency, call your local emergency number.

When this does not apply. MELD 3.0 was built from adults 18 and older with chronic liver disease on the US liver transplant waiting list (Kim 2021). It does not apply to children, to acute liver failure, or to people who already had a liver transplant. It does not decide transplant priority: the transplant network applies its own rules.

How the score is worked out

"ln" is the natural logarithm. Bilirubin and creatinine are in mg/dL, albumin in g/dL, sodium (Na) in mmol/L (the same number as mEq/L). SI values are converted first: bilirubin µmol/L ÷ 17.1, creatinine µmol/L ÷ 88.4, albumin g/L ÷ 10.

MELD 3.0 (Kim 2021)

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

Before the formula, each value is held inside its bounds:

  • bilirubin, INR, and creatinine below 1.0 count as 1.0
  • creatinine above 3.0 counts as 3.0, and counts as 3.0 after dialysis twice or more in the past week (or 24 hours of continuous dialysis)
  • sodium counts between 125 and 137
  • albumin counts between 1.5 and 3.5

The result is rounded to the nearest whole number (halves round up, read from the decimal value: a result within 1e-9 (relative) of a half counts as the half, so 2.005 rounds to 2.01).

Original MELD (as stated in Kim 2021)

MELD = 9.57 × ln(creatinine) + 3.78 × ln(bilirubin) + 11.20 × ln(INR) + 6.43, rounded to a whole number.

Bilirubin, INR, and creatinine below 1.0 count as 1.0. Creatinine of 4.0 or more, or dialysis twice or more in the past week, counts as 4.0.

MELD-Na

If the rounded MELD is over 11: MELD-Na = MELD + 1.32 × (137 − Na) − 0.033 × MELD × (137 − Na), rounded to a whole number, with sodium held between 125 and 137. If MELD is 11 or less, MELD-Na equals MELD.

With MELD 3.0 or MELD-Na picked, the page also shows the other scores for the same labs. The US transplant network caps allocation scores at 40; this page shows the score as calculated.

Inputs the calculator accepts

Bilirubin 0.1 to 80 mg/dL, INR 0.5 to 15, creatinine 0.1 to 20 mg/dL, sodium 100 to 180 mmol/L, albumin 0.5 to 7 g/dL. Values outside the bounds above are still accepted and then held at the bound, as the formulas say.

Worked examples by hand

Low-risk man (Kim 2021, Table 4). Bilirubin 2.5, Na 131, INR 1.0, creatinine 1.2, albumin 3.8 (counts as 3.5). ln 2.5 = 0.91629, ln 1.2 = 0.18232. MELD 3.0 = 4.56 × 0.91629 + 0.82 × 6 − 0.24 × 6 × 0.91629 + 0 + 11.14 × 0.18232 + 0 − 0 + 6 = 4.17828 + 4.92 − 1.31946 + 2.03105 + 6 = 15.81, rounded to 16. MELD = 9.57 × 0.18232 + 3.78 × 0.91629 + 0 + 6.43 = 11.64, rounded to 12. MELD-Na = 12 + 1.32 × 6 − 0.033 × 12 × 6 = 17.54, rounded to 18. The paper's table gives 16, 12, and 18.

Intermediate-risk woman (Table 4). Bilirubin 6.0, Na 131, INR 1.5, creatinine 1.5, albumin 2.2: MELD 3.0 = 27.48, rounded to 27; MELD 22; MELD-Na 26. The table gives 27, 22, and 26.

High-risk man in SI units (Table 4). Bilirubin 205.2 µmol/L = 12 mg/dL, creatinine 247.52 µmol/L = 2.8 mg/dL, albumin 20 g/L = 2.0 g/dL, INR 2.2, Na 128: MELD 3.0 = 37.93, rounded to 38; MELD 35; MELD-Na 36.49, rounded to 36. The table gives 38, 35, and 36.

MELD-Na with creatinine 1.8 (Table 4). Bilirubin 12, INR 2.2, creatinine 1.8, Na 128: MELD = 30; MELD-Na = 30 + 1.32 × 9 − 0.033 × 30 × 9 = 32.97, rounded to 33.

Original MELD with values below the floor. Bilirubin 0.8 and INR 0.9 count as 1.0, and creatinine 5.0 counts as 4.0: MELD = 9.57 × ln 4 + 6.43 = 19.70, rounded to 20.

Limits

MELD scores were built for adults with chronic liver disease, most of them on or near the transplant list. They do not replace a hepatologist's judgment, and transplant priority also depends on exception points and other policy rules.

Other questions people ask

What is the MELD score?

The Model for End-Stage Liver Disease (MELD) is a score from lab tests that estimates the risk of death within 3 months for a person with chronic liver disease. In the US it sets the order of the liver transplant waiting list. Higher scores mean higher risk.

What is MELD 3.0?

MELD 3.0 (Kim and others, 2021) updates MELD-Na. It adds sex and albumin, adds two interaction terms (bilirubin with sodium, creatinine with albumin), and lowers the creatinine ceiling from 4.0 to 3.0 mg/dL. It predicted 90-day survival slightly better than MELD-Na and reduced the disadvantage that women had under MELD-Na. The US transplant network (OPTN) adopted it for liver allocation in 2023.

What is a normal MELD score?

There is no "normal" MELD score, because it is only used for people with liver disease. The lowest possible score is 6. In the MELD 3.0 paper, a score of 20 went with a predicted 90-day mortality of 5.4%, and the high-risk examples scored in the high 30s.

What is the difference between MELD and MELD-Na?

MELD uses bilirubin, INR, and creatinine. MELD-Na adds serum sodium, because a low sodium adds risk. The sodium term applies only when MELD is over 11.

Why does dialysis change the score?

Dialysis lowers the creatinine in the blood, so the measured value no longer shows kidney function. After two or more dialysis sessions in the past week, or 24 hours of continuous dialysis, the creatinine counts at its ceiling (3.0 mg/dL for MELD 3.0, 4.0 for MELD and MELD-Na).