# What is my MELD score?

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.

- Page: https://www.acalculator.org/health/meld-score-calculator
- JSON spec: https://www.acalculator.org/health/meld-score-calculator.json
- Version: c1be2995539a

## Default answer

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.

## Inputs

| Key | Label | Description |
| --- | --- | --- |
| score | Score | Which score: MELD 3.0 (current US allocation), MELD-Na, or the original MELD. |
| units | Lab units | US units (mg/dL, g/dL) or SI units (µmol/L, g/L) for bilirubin, creatinine, and albumin. |
| sex | Sex | Sex at birth. MELD 3.0 adds 1.33 points for women. |
| bili | Bilirubin (mg/dL) | Total serum bilirubin, in mg/dL. |
| biliSi | Bilirubin (µmol/L) | Total serum bilirubin, in µmol/L. |
| inr | INR | International normalized ratio of the prothrombin time. |
| cr | Creatinine (mg/dL) | Serum creatinine, in mg/dL. |
| crSi | Creatinine (µmol/L) | Serum creatinine, in µmol/L. |
| dialysis | Dialysis twice or more in the past week | 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. |
| na | Sodium (mmol/L) | Serum sodium, in mmol/L (the same number as mEq/L). |
| alb | Albumin (g/dL) | Serum albumin, in g/dL. |
| albSi | Albumin (g/L) | Serum albumin, in g/L. |

## Outputs

| Key | Label | Description |
| --- | --- | --- |
| score | Score | The chosen score, a whole number (6 and up). |
| name | Score used | Which MELD score the headline is. |
| meld | Original MELD | The original MELD score for the same labs, for comparison. |
| meldNa | MELD-Na | The MELD-Na score for the same labs, for comparison. |

## 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).

## Worked examples

1. score = meld3, units = us, sex = male, bili = 2.5, inr = 1, cr = 1.2, dialysis = no, na = 131, alb = 3.8 gives 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.
2. score = meld3, units = us, sex = female, bili = 6, inr = 1.5, cr = 1.5, dialysis = no, na = 131, alb = 2.2 gives 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.
3. score = meld3, units = si, sex = male, biliSi = 205.2, inr = 2.2, crSi = 247.52, dialysis = no, na = 128, albSi = 20 gives 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.
4. score = meldna, units = us, bili = 12, inr = 2.2, cr = 1.8, dialysis = no, na = 128 gives score = 33, meld = 30, meldNa = 33. Source: Kim et al. 2021, Table 4 (high risk, creatinine 1.8): MELD 30, MELDNa 33.
5. score = meld, units = us, bili = 0.8, inr = 0.9, cr = 5, dialysis = no gives 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.

## FAQ

### 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).

## 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)