MELD Score (Liver Disease)
Chronic liver disease severity and 90-day mortality prognosis.
About this calculator
The MELD score (Model for End-stage Liver Disease) predicts 3-month mortality in cirrhosis. Developed by Kamath et al. (Hepatology, 2001) originally for TIPS risk, and since 2002 the primary criterion for US liver transplant allocation (UNOS). Formula: MELD = 3.78 × ln(bilirubin) + 11.2 × ln(INR) + 9.57 × ln(creatinine) + 6.43. Minimum 6, maximum 40. Interpretation of 3-month mortality. <9 – 1.9%. 10-19 – 6%. 20-29 – 19.6%. 30-39 – 52.6%. >=40 – 71.3%. Patients with MELD >=17 are considered for transplant listing; >=25 – high priority. Clinical use. Liver transplant listing stratification. Survival prognosis in decompensated cirrhosis. Decisions on palliative care at end stage. Before MELD, Child-Pugh was widely used, but MELD discriminates severe patients more accurately. Limitations of original MELD. Does not capture hyponatremia, diuretic-refractory ascites, hepatorenal syndrome. Patients with relatively low MELD (<20) and severe ascites or hyponatremia have worse prognosis than predicted. Since 2016 the US uses MELD-Na (sodium-corrected); since 2023 – MELD 3.0 (sex, albumin, sodium-corrected). Exception points. Hepatocellular carcinoma within Milan criteria, hepatopulmonary syndrome, portopulmonary hypertension, amyloidosis, cystic fibrosis, primary hyperoxaluria. These patients receive UNOS exception points raising priority regardless of laboratory MELD.
Source
Formula version: kamath-2001-v1
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