mg/dL
mg/dL
MELD Score Interpretation
- < 10: Low 3-month mortality risk
- 10 - 19: Moderate 3-month mortality risk
- 20 - 29: High 3-month mortality risk
- ≥ 30: Very high 3-month mortality risk
Important Notes
- MELD = 3.78 × ln(bilirubin) + 11.2 × ln(INR) + 9.57 × ln(creatinine) + 6.43
- Use serum bilirubin (mg/dL), INR, and serum creatinine (mg/dL)
- If patient had dialysis ≥ 2 times in past week, use creatinine = 4.0 mg/dL
- Minimum value for each lab is 1.0
- Do not use in acute liver failure
MELD Score Calculator
The MELD (Model for End-Stage Liver Disease) score is a validated tool used to assess the severity of chronic liver disease and prioritize patients for liver transplantation. It predicts 3-month mortality risk and is used by transplant centers worldwide for organ allocation.
MELD Formula
- Use serum bilirubin (mg/dL), INR, and serum creatinine (mg/dL)
- If patient had dialysis ≥ 2 times in past week, use creatinine = 4.0 mg/dL
- Minimum value for each lab is 1.0
Interpretation
- < 10: Low 3-month mortality risk
- 10 - 19: Moderate 3-month mortality risk
- 20 - 29: High 3-month mortality risk
- ≥ 30: Very high 3-month mortality risk
Clinical Applications
- Liver Transplantation: MELD is the primary tool for organ allocation in adults with chronic liver disease.
- Prognosis: Higher MELD scores indicate greater short-term mortality risk.
- Management: Guides timing of referral for transplant evaluation and prioritization on the waitlist.
Limitations
- Not validated for acute liver failure, cholestatic, or metabolic liver diseases.
- Does not account for all complications (e.g., hepatic encephalopathy, ascites).
- May underestimate risk in patients with low muscle mass (sarcopenia) or those on dialysis.
Important Considerations
- Always interpret MELD in the context of the full clinical picture.
- Consult transplant hepatology for patients with high or rapidly rising MELD scores.
- Document MELD score and calculation date in the medical record.
References
- Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464-470.
- UNOS Policy: optn.transplant.hrsa.gov
- Wiesner RH, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124(1):91-96.
- Kim WR, et al. MELD and PELD: application of survival models to liver allocation. Liver Transpl. 2002;8(9):S109-S114.
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