MELD & MELD-Na Calculator – Free Calculator

Understanding the MELD and MELD-Na calculator — concept and principle

The MELD score (Model for End-Stage Liver Disease) predicts the risk of death within about three months in people with advanced chronic liver disease. It uses only routine laboratory values, which makes it objective and reproducible. MELD and its sodium-adjusted version, MELD-Na, have been used to prioritise patients on liver transplant waiting lists and to assess risk before procedures.

With the default labs, MELD rounds to 15 and the sodium adjustment lifts MELD-Na to 17.

How it is calculated

MELD = 10 × (0.957 × ln creatinine + 0.378 × ln bilirubin + 1.120 × ln INR + 0.643)

Creatinine and bilirubin in mg/dL; ln is the natural logarithm.
Any value below 1 is set to 1, so its logarithm is never negative.
Creatinine is capped at 4 mg/dL, and set to 4 if the patient had dialysis at least twice in the past week.

MELD-Na = MELD + 1.32 × (137 − Na) − 0.033 × MELD × (137 − Na), applied only when MELD is above 11. Sodium is limited to the range 125–137 mmol/L.

The principle

MELD was derived by regression from patients whose survival was followed. Kidney function (creatinine), bile excretion (bilirubin) and clotting-factor synthesis (INR) were the strongest independent predictors. Using logarithms means that each doubling of a lab value adds a fixed number of points. Later work showed that low sodium adds risk, especially when MELD is low or moderate, which is why the sodium term shrinks as MELD rises.

Worked example

ln 1.2 = 0.1823, × 0.957 = 0.1745.
ln 2 = 0.6931, × 0.378 = 0.2620.
ln 1.5 = 0.4055, × 1.12 = 0.4541.
MELD(i) = 0.1745 + 0.2620 + 0.4541 + 0.643 = 1.5336; as in the OPTN policy it is rounded to the tenth first, 1.5, so MELD = 1.5 × 10 = 15.
Sodium 134, so 137 − 134 = 3. MELD-Na = 15 + 1.32 × 3 − 0.033 × 15 × 3 = 15 + 3.96 − 1.485 = 17.475, rounded to 17.

Each point is the calculator re-run with only “INR” changed; the gold point is the default example. Change the inputs above and this chart follows your numbers.

INR	MELD-Na
0.375	11
0.75	11
1.12	15
1.5	17
1.88	20
2.25	22
3	25

How to read the result

Where does your result fall?

Scores run from 6 upward and are usually reported to a maximum of 40. Short-term mortality rises steeply with the score: values below about 10 indicate low short-term risk, while scores in the 30s carry a very high risk. Transplant evaluation is commonly discussed once MELD reaches about 15. The United States moved to MELD 3.0, which adds sex and albumin, in 2023, so official allocation scores may differ from this result.

Common mistakes

Entering creatinine or bilirubin in µmol/L; the formula requires mg/dL.
Using an INR raised by warfarin, which inflates the score.
Forgetting the dialysis setting, which fixes creatinine at 4.

Keep in mind: MELD is not a diagnosis and this calculator does not apply the cap at 40 used in allocation. It does not capture complications such as refractory ascites or liver cancer. Decisions belong to a hepatology or transplant team.

Frequently asked questions

What MELD score is considered high?

Scores above about 20 indicate substantial short-term risk, and 30 or more is very high.

Why does low sodium raise the score?

Hyponatraemia reflects worsening circulation in cirrhosis and independently predicts death.

What is MELD 3.0?

An updated model adding female sex and albumin, with revised coefficients, used for US allocation since 2023.

Sources: Kamath PS et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001. · Kim WR et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med 2008.

Checked 8 Nov 2026. Kamath et al., Hepatology 2001; Kim et al., NEJM 2008.

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