{
  "id": "meld-score",
  "version": "c1be2995539a",
  "status": "published",
  "name": "MELD Score Calculator",
  "question": "What is my MELD score?",
  "summary": "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.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/meld-score-calculator",
  "markdown": "https://www.acalculator.org/health/meld-score-calculator.md",
  "kind": "function",
  "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.",
  "assumptions": [
    "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)."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "score": {
        "title": "Score",
        "description": "Which score: MELD 3.0 (current US allocation), MELD-Na, or the original MELD.",
        "type": "string",
        "enum": [
          "meld3",
          "meldna",
          "meld"
        ]
      },
      "units": {
        "title": "Lab units",
        "description": "US units (mg/dL, g/dL) or SI units (µmol/L, g/L) for bilirubin, creatinine, and albumin.",
        "type": "string",
        "enum": [
          "us",
          "si"
        ]
      },
      "sex": {
        "title": "Sex",
        "description": "Sex at birth. MELD 3.0 adds 1.33 points for women.",
        "type": "string",
        "enum": [
          "male",
          "female"
        ]
      },
      "bili": {
        "title": "Bilirubin (mg/dL)",
        "description": "Total serum bilirubin, in mg/dL.",
        "type": "number",
        "minimum": 0.1,
        "maximum": 80
      },
      "biliSi": {
        "title": "Bilirubin (µmol/L)",
        "description": "Total serum bilirubin, in µmol/L.",
        "type": "number",
        "minimum": 1.71,
        "maximum": 1368
      },
      "inr": {
        "title": "INR",
        "description": "International normalized ratio of the prothrombin time.",
        "type": "number",
        "minimum": 0.5,
        "maximum": 15
      },
      "cr": {
        "title": "Creatinine (mg/dL)",
        "description": "Serum creatinine, in mg/dL.",
        "type": "number",
        "minimum": 0.1,
        "maximum": 20
      },
      "crSi": {
        "title": "Creatinine (µmol/L)",
        "description": "Serum creatinine, in µmol/L.",
        "type": "number",
        "minimum": 8.84,
        "maximum": 1768
      },
      "dialysis": {
        "title": "Dialysis twice or more in the past week",
        "description": "Two or more dialysis sessions in the past 7 days, or 24 hours of continuous dialysis (CVVHD). The creatinine is then set to the ceiling.",
        "type": "boolean"
      },
      "na": {
        "title": "Sodium (mmol/L)",
        "description": "Serum sodium, in mmol/L (the same number as mEq/L).",
        "type": "number",
        "minimum": 100,
        "maximum": 180
      },
      "alb": {
        "title": "Albumin (g/dL)",
        "description": "Serum albumin, in g/dL.",
        "type": "number",
        "minimum": 0.5,
        "maximum": 7
      },
      "albSi": {
        "title": "Albumin (g/L)",
        "description": "Serum albumin, in g/L.",
        "type": "number",
        "minimum": 5,
        "maximum": 70
      }
    }
  },
  "outputs": {
    "score": {
      "label": "Score",
      "description": "The chosen score, a whole number (6 and up).",
      "format": "integer"
    },
    "name": {
      "label": "Score used",
      "description": "Which MELD score the headline is.",
      "format": "text"
    },
    "meld": {
      "label": "Original MELD",
      "description": "The original MELD score for the same labs, for comparison.",
      "format": "integer"
    },
    "meldNa": {
      "label": "MELD-Na",
      "description": "The MELD-Na score for the same labs, for comparison.",
      "format": "integer"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "score": "meld3",
      "units": "us",
      "sex": "male",
      "bili": 2.5,
      "biliSi": 43,
      "inr": 1,
      "cr": 1.2,
      "crSi": 106,
      "dialysis": false,
      "na": 131,
      "alb": 3.8,
      "albSi": 38
    },
    "outputs": {
      "score": 16,
      "name": "MELD 3.0",
      "meld": 12,
      "meldNa": 18
    },
    "text": "The MELD 3.0 score is 16."
  },
  "examples": [
    {
      "given": {
        "score": "meld3",
        "units": "us",
        "sex": "male",
        "bili": 2.5,
        "inr": 1,
        "cr": 1.2,
        "dialysis": false,
        "na": 131,
        "alb": 3.8
      },
      "expect": {
        "score": 16,
        "meld": 12,
        "meldNa": 18
      },
      "source": "Kim et al., Gastroenterology 2021, Table 4 (low risk, male): MELD 12, MELDNa 18, MELD 3.0 16; unrounded MELD 3.0 15.81 (Python 3 check)"
    },
    {
      "given": {
        "score": "meld3",
        "units": "us",
        "sex": "female",
        "bili": 6,
        "inr": 1.5,
        "cr": 1.5,
        "dialysis": false,
        "na": 131,
        "alb": 2.2
      },
      "expect": {
        "score": 27,
        "meld": 22,
        "meldNa": 26
      },
      "source": "Kim et al. 2021, Table 4 (intermediate risk, female, albumin 2.2): MELD 22, MELDNa 26, MELD 3.0 27"
    },
    {
      "given": {
        "score": "meld3",
        "units": "si",
        "sex": "male",
        "biliSi": 205.20000000000002,
        "inr": 2.2,
        "crSi": 247.52,
        "dialysis": false,
        "na": 128,
        "albSi": 20
      },
      "expect": {
        "score": 38,
        "meld": 35,
        "meldNa": 36
      },
      "source": "Kim et al. 2021, Table 4 (high risk, male, creatinine 2.8): MELD 35, MELDNa 36, MELD 3.0 38"
    },
    {
      "given": {
        "score": "meldna",
        "units": "us",
        "bili": 12,
        "inr": 2.2,
        "cr": 1.8,
        "dialysis": false,
        "na": 128
      },
      "expect": {
        "score": 33,
        "meld": 30,
        "meldNa": 33
      },
      "source": "Kim et al. 2021, Table 4 (high risk, creatinine 1.8): MELD 30, MELDNa 33"
    },
    {
      "given": {
        "score": "meld",
        "units": "us",
        "bili": 0.8,
        "inr": 0.9,
        "cr": 5,
        "dialysis": false
      },
      "expect": {
        "score": 20,
        "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; 9.57 × ln 4 + 6.43 = 19.70, rounded to 20 (hand calculation in content.mdx)"
    }
  ],
  "sources": [
    "Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0: the Model for End-Stage Liver Disease updated for the modern era. Gastroenterology. 2021;161(6):1887-1895.e4. https://doi.org/10.1053/j.gastro.2021.08.050 (full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608337/, retrieved 2026-09-28)",
    "Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018-1026. https://doi.org/10.1056/NEJMoa0801209 (MELD-Na; retrieved 2026-09-28)",
    "Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464-470. https://doi.org/10.1053/jhep.2001.22172 (original MELD; retrieved 2026-09-28)",
    "Organ Procurement and Transplantation Network, Policy 9: Allocation of Livers and Liver-Intestines. https://optn.transplant.hrsa.gov/policies-bylaws/policies/ (retrieved 2026-09-28)"
  ],
  "related": [],
  "changelog": [
    {
      "date": "2026-09-29",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notice says so."
    }
  ]
}