MELD Score: The Complete Clinical Guide
What MELD measures, formula, MELD-Na, 90-day mortality, transplant criteria, and clinical management by score range
What Is the MELD Score?
The Model for End-Stage Liver Disease (MELD) is a validated prognostic scoring system for patients with chronic liver disease. Developed by Kamath et al. at the Mayo Clinic in 2001, it uses three objective laboratory values — serum creatinine, bilirubin, and INR — to predict 90-day mortality without transplantation. It replaced the Child-Pugh score for organ allocation in the US (UNOS, 2002) and is now used globally for transplant listing prioritisation.
MELD-Na incorporates serum sodium to improve predictive accuracy, particularly in patients with hyponatraemia — a marker of advanced portal hypertension. MELD-Na is now used by UNOS and NHSBT for transplant allocation.
MELD-Na = MELD + 1.32×(137−Na) − [0.033×MELD×(137−Na)]
Minimum value 1.0 for each variable. Creatinine capped at 4.0 if on dialysis.
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- 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.
- Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359:1018-1026.
- EASL Clinical Practice Guidelines on liver transplantation. J Hepatol. 2022.
- NHSBT. Liver transplantation: selection criteria and recipient registration. Policy POL195/8. Updated 2023.
⚠️ Medical Disclaimer: MELD score is for educational and documentation purposes only. Transplant listing decisions are made by accredited transplant centres. MedDraftPro accepts no clinical liability.