Meld Calculator - Mayo MELD, MELD-Na, and MELD 3.0

A MELD calculator is a clinical worksheet that turns four routine lab values into the Model for End-Stage Liver Disease score used by hepatology and transplant teams. This page applies the original Mayo formula and the MELD-Na adjustment, which shaped US liver allocation from 2016 to July 2023; current US adult allocation has used MELD 3.0 since July 13, 2023.

• • Adult chronic liver disease review: Track severity over time when cirrhosis, alcohol-related liver disease, or fatty liver disease is being monitored.
• • Liver transplant listing discussion: Compare current labs with the MELD-Na value that shaped US allocation from 2016 to 2023, then ask the transplant center about the current MELD 3.0 score.
• • Hepatorenal syndrome workup: Watch how the creatinine component changes the MELD when kidney function shifts in advanced liver disease.
• • Pre-procedure risk conversation: Estimate perioperative risk for elective surgery, TIPS evaluation, or other procedures that depend on liver synthetic function.

The MELD score was developed in 2000 at the Mayo Clinic to predict three-month mortality in patients undergoing transjugular intrahepatic portosystemic shunt placement. It became the foundation of US organ allocation because the three core lab values are objective and can be measured almost anywhere.

Because the MELD score combines liver labs with a kidney value, the GFR Calculator is a useful companion when you want to put the creatinine component in context.

This page applies the original Mayo equation to three log-transformed lab values, rounds the result, caps it at 40, and adds the MELD-Na sodium correction. The current US allocation score, MELD 3.0, is discussed below; this calculator does not compute MELD 3.0 because it does not collect the extra inputs that MELD 3.0 requires.

• Bilirubin: Total serum bilirubin in mg/dL, floored at 1.0.
• INR: International normalized ratio, floored at 1.0.
• Creatinine: Serum creatinine in mg/dL, floored at 1.0, capped at 4.0, and forced to 4.0 on twice-weekly or more frequent dialysis.
• Sodium: Serum sodium in mmol/L, clamped to 125-137 for the MELD-Na correction.

The MELD-Na step adds a sodium term that grows larger as the MELD score rises and the sodium falls. MELD 3.0 replaces this sodium term with a different set of adjustments, so the MELD-Na result on this page is a useful severity estimate but no longer matches the US allocation score.

According to Malinchoc et al. (Hepatology, 2000), the original MELD formula multiplies the natural logarithm of serum bilirubin by 3.78, the natural logarithm of INR by 11.2, and the natural logarithm of serum creatinine by 9.57, then adds 6.43, with bilirubin, INR, and creatinine floored at 1.0 and creatinine capped at 4.0.

The MELD score focuses on synthetic liver function and the kidney, while the APRI Calculator tracks the same liver from a different angle using AST and platelet count.

Four concepts help interpret the MELD score correctly. They explain why each lab value is treated the way it is, what the resulting numbers mean for clinical review, and how the current US allocation score relates to the MELD-Na result shown here.

Risk bands are population estimates from the original transplant cohort. Individual outcomes vary with age, infection, alcohol use, hepatocellular carcinoma, and other factors the formula does not include.

The MELD calculator reads synthetic liver function from bilirubin, INR, and creatinine, whereas the AST ALT Ratio reviews hepatocellular injury from a different pair of labs.

Use the calculator with the most recent labs from the same blood draw. The four inputs and one context toggle cover the entire Mayo formula, and the MELD-Na correction is applied automatically.

1. 1 Enter total serum bilirubin: Use the total bilirubin result in mg/dL. Values below 1.0 are floored at 1.0.
2. 2 Enter the INR from the same draw: Use the international normalized ratio rather than prothrombin time. Anticoagulation can change the INR.
3. 3 Enter serum creatinine and dialysis context: Type the creatinine in mg/dL. Set the dialysis toggle to yes with at least two sessions in the past seven days or 24 hours of CRRT.
4. 4 Enter serum sodium: Use the most recent sodium value in mmol/L. The calculator clamps sodium to 125-137.
5. 5 Read both scores together: Compare the MELD and MELD-Na scores. The sodium correction shows how much sodium contributed.
6. 6 Match the result to the next clinical step: Use the displayed risk band to guide the hepatology or transplant-center conversation. The calculator does not change listing status.

A clinician evaluating a 54-year-old with cirrhosis enters bilirubin 2.5 mg/dL, INR 1.5, creatinine 1.5 mg/dL, sodium 135 mmol/L, and dialysis no. The MELD score is 18, the MELD-Na score is 20, the risk tier is moderate, and the result is a starting point for the transplant-center conversation.

When low sodium is part of the picture, the Anion Gap Calculator can help review the broader electrolyte context around the MELD-Na correction.

The score is most useful when the same labs are reviewed over time and compared against a single, transparent formula. The benefits below are framed for adult chronic liver disease and separate the MELD-Na result computed here from the MELD 3.0 score transplant centers use for current US allocation.

• • Objective severity tracking: Three lab values are combined with fixed coefficients, removing much of the variability between clinicians interpreting severity.
• • Historical allocation math: The MELD-Na formula shown here matches the score that shaped US adult liver allocation from January 2016 through July 2023, which is useful when reading older transplant notes.
• • Sodium insight in one step: The MELD-Na step and the sodium correction in points make it easy to see how much of the change in the score is driven by low sodium.
• • Track-friendly revisit: The same calculator can be rerun with new labs at each visit, giving a defensible trend for outpatient monitoring.
• • Bedside-friendly inputs: The four labs and one context toggle are available in nearly every hospital and most outpatient labs.

For transplant-center conversations, run the calculator immediately before the call so the most recent labs are reflected, and ask the coordinator for the MELD 3.0 value that drives the current listing decision. For outpatient monitoring, save the result with the date and the same lab panel.

Synthetic liver function shows up in both the MELD score and protein panels, so the Albumin Globulin Ratio Calculator offers a complementary view when the MELD result is being interpreted.

The MELD score is sensitive to the four lab values and to the choices made in the boundary rules. The factors below describe what can change the result, and the limitations note the cases the formula does not capture, including the parts of the current US allocation score that this calculator does not show.

• • The MELD and MELD-Na scores here do not include the female sex term, serum albumin, or ascites grade that MELD 3.0 uses, so the result may diverge from the current US allocation score.
• • Transplant centers can request exception points for conditions the formula does not cover, so a low calculated MELD-Na does not rule out active listing. Always confirm the displayed status with the transplant program and ask which score is being used to set priority.

Outside the United States, allocation systems may use MELD variants such as the UKELD. In the United States, the MELD-Na result on this page matches the prior 2016 policy, not the MELD 3.0 policy in force today.

According to OPTN/UNOS policy, US adult liver allocation transitioned to the MELD 3.0 score on July 13, 2023, replacing the MELD-Na score that had been used since January 2016.

According to Kim et al. (Hepatology, 2008), the MELD-Na equation adds 1.32 x (137 - sodium) and subtracts 0.033 x MELD x (137 - sodium) from the original MELD score, which is why the sodium correction grows larger when the MELD is high and the sodium is low.

When anticoagulation or vitamin K deficiency pushes the INR input up, the FFP Dose Calculator helps review the plasma volume and bag count needed to bring the international normalized ratio back toward a target range before an invasive procedure.