MELD Score

Predicts 3-month mortality in end-stage liver disease; prioritizes organ allocation for liver transplant

Indication

Predicts 3-month mortality in end-stage liver disease; prioritizes organ allocation for liver transplant

id: creatinine; label: Creatinine (mg/dL); type: number; min: 0.1; max: 40; step: 0.1
id: bilirubin; label: Total Bilirubin (mg/dL); type: number; min: 0.1; max: 100; step: 0.1
id: inr; label: INR; type: number; min: 0.1; max: 20; step: 0.1
id: sodium; label: Sodium (mEq/L); type: number; min: 100; max: 160; step: 1
id: dialysis; label: Dialysis at least twice in past week; type: yesno

function(score, vals) { var cr = Math.max(1, Math.min(parseFloat(vals.creatinine) || 1, 4)); if (vals.dialysis) cr = 4; var bil = Math.max(1, parseFloat(vals.bilirubin) || 1); var inr = Math.max(1, parseFloat(vals.inr) || 1); var na = Math.max(125, Math.min(parseFloat(vals.sodium) || 140, 137)); var meld = 10 * (0.957 * Math.log(cr) + 0.378 * Math.log(bil) + 1.120 * Math.log(inr) + 0.643); meld = Math.round(meld * 10) / 10; var meldNa = meld - na - (0.025 * meld * (140 - na)) + 140; meldNa = Math.round(Math.max(6, Math.min(meldNa, 40))); if (meldNa <= 9) return { risk: 'MELD-Na ' + meldNa, tier: 'Low', action: '1.9% 3-month mortality. Monitor; not yet transplant priority.', color: 'green' }; if (meldNa <= 19) return { risk: 'MELD-Na ' + meldNa, tier: 'Moderate', action: '6% 3-month mortality. Optimize nutrition, follow closely.', color: 'yellow' }; if (meldNa <= 29) return { risk: 'MELD-Na ' + meldNa, tier: 'High', action: '19.6% 3-month mortality. List for transplant evaluation.', color: 'red' }; return { risk: 'MELD-Na ' + meldNa, tier: 'Very High', action: '52.6% 3-month mortality. Urgent transplant evaluation.', color: 'red' }; }

MELD-Na replaced MELD for transplant listing in 2016
Cap creatinine at 4.0; if dialysis >= 2x/week, auto set Cr=4
Sodium capped at 125-137 for MELD-Na calculation
MELD does not capture portal hypertension complications well — exception points may be granted

Kamath et al., Hepatology 2001; Kim et al., Hepatology 2008. Last reviewed: 2024-11-01