MELD Score Calculator

Reviewed by Hamza Gujjar, Algorithm Architect & Software Developer Last updated: August 20, 2026

Disclaimer: This calculator is provided for informational and educational purposes only and does not constitute financial, medical, legal, or other professional advice. Always consult a qualified professional before making decisions based on these results.

📚 Confused about how this is calculated? Read the full How Do You Fairly Decide Who Gets the Liver? →

Three Numbers, One Score

The MELD score began life in 2001 as a tool for predicting survival after a specific liver procedure, and was rapidly repurposed into something far more consequential: a way to rank candidates for liver transplantation by medical urgency rather than by waiting time. It condenses three routine laboratory values — bilirubin, INR and creatinine — into a single integer between 6 and 40. This calculator implements the original 2002 formulation.

The Formula

MELD = 3.78 × ln(Bilirubin) + 11.2 × ln(INR) + 9.57 × ln(Creatinine) + 6.43

Any value below 1.0 is set to 1.0
Creatinine is capped at 4.0, or set to 4.0 if on dialysis
The result is rounded and clamped to the range 6–40

The natural logarithms are the heart of it. They compress the top of each lab range so that a bilirubin moving from 20 to 25 shifts the score far less than a move from 2 to 7 does. The 1.0 floor exists to stop normal or low values from contributing negative terms — ln(1.0) is exactly zero, which is why a patient with all three values at or below 1.0 lands on the floor score of 6, from the constant 6.43 alone.

Worked Examples

Each row was computed with the formula above, including the flooring, capping and clamping steps:

MELD score for sample laboratory combinations
Bilirubin (mg/dL)	INR	Creatinine (mg/dL)	MELD
1.0	1.0	1.0	6
2.0	1.3	1.2	14
4.0	1.8	1.5	22
8.0	2.5	2.5	33
15.0	3.0	3.5	40

The first row is the arithmetic floor: with every input at 1.0, all three logarithmic terms vanish and only the 6.43 constant survives, rounding to 6.

Why Each Input Is There

What the three MELD components represent
Input	Coefficient	What it reflects
Bilirubin	3.78	The liver's capacity to clear and excrete bile pigment
INR	11.2	Synthetic function — the liver manufactures clotting factors
Creatinine	9.57	Kidney function, which deteriorates alongside advanced liver disease

The largest coefficient sits on INR, which is worth pausing over. INR moves over a narrow numeric range compared with bilirubin, so a large multiplier is needed for it to carry comparable weight. Coefficient size reflects scaling as much as it reflects importance.

The Dialysis Rule

Setting creatinine to 4.0 for a dialysed patient is a deliberate correction rather than an approximation. Dialysis artificially lowers measured creatinine, so a patient in renal failure could otherwise post a deceptively reassuring value precisely because they are being treated for the problem the score is trying to detect. Fixing the input at the cap prevents the treatment from masking the severity.

Where the Score Is Used

Transplant allocation — MELD and its later variants underpin how liver waiting lists are prioritised in several national systems.
Prognostic discussion — the score gives clinicians a shared, quantitative vocabulary for disease severity.
Procedural risk — it is frequently referenced when weighing surgery in patients with cirrhosis.
Tracking trajectory — a score that climbs across serial measurements says more than any single value.

Note: This calculator reproduces the original 2002 MELD arithmetic for general reference and education. It is not medical advice, not a prognosis, and not the allocation score any transplant programme actually uses — several jurisdictions have moved to MELD-Na, MELD 3.0 or other revisions incorporating additional variables. Any question about liver disease belongs with a hepatologist or your own physician.

How to Use This Calculator

Enter Bilirubin (mg/dL) — total bilirubin from a standard liver panel.
Enter INR, the international normalised ratio from coagulation testing.
Enter Creatinine (mg/dL).
Choose Not on Dialysis or On Dialysis (2+ times in past week) — selecting dialysis overrides the creatinine you entered and fixes it at 4.0.
Select Calculate. The output traces every adjustment, so you can see exactly which values were floored, capped or clamped before the logarithms were taken.

Related Calculations

Creatinine drives one of the three MELD terms — explore it directly with the eGFR Calculator or the Creatinine Clearance Calculator.

Principles of Liver Transplant Allocation: The MELD Score

The Model for End-Stage Liver Disease (MELD) Score is a validated numerical scoring system predicting 90-day mortality risk in patients with chronic liver cirrhosis. In transplant hepatology, MELD determines organ allocation priority on the United Network for Organ Sharing (UNOS) national liver transplant waiting list.

The MELD-Na Scoring Formula

Original MELD = 10 × [ 0.957 × ln(Creatinine) + 0.378 × ln(Bilirubin) + 1.120 × ln(INR) + 0.643 ]
MELD-Na Adjustment = MELD + 1.32 × ( 137 - Sodium ) - [ 0.033 × MELD × ( 137 - Sodium ) ]
All laboratory values are clamped: minimum Creatinine = 1.0 mg/dL; Sodium range = 125 to 137 mEq/L

MELD Score Ranges and Clinical Interpretation

MELD Score Range	Estimated 90-Day Mortality	Clinical Status
< 10	< 2%	Compensated cirrhosis; stable outpatient monitoring
10 to 19	6% to 20%	Moderate liver dysfunction; transplant evaluation warranted
20 to 29	20% to 45%	Severe liver disease; active transplant listing
≥ 30	50% to 80%+	Critical end-stage liver failure; UNOS top-priority listing

MELD Exception Points for Hepatocellular Carcinoma (HCC)

Patients diagnosed with early-stage liver cancer (HCC within Milan Criteria: single tumor ≤ 5 cm or up to 3 tumors each ≤ 3 cm) receive MELD Exception Points, artificially increasing their calculated MELD score to reflect the urgency of transplantation before tumor progression renders them ineligible.

The New MELD 3.0 Update (2022)

UNOS introduced MELD 3.0 incorporating serum albumin and sex-based coefficients to improve waitlist mortality prediction and address documented sex-based disparities in organ allocation, replacing the prior MELD-Na formula as the standard transplant scoring system.

Transjugular Intrahepatic Portosystemic Shunt (TIPS) and MELD

Hepatologists utilize the MELD score to guide TIPS Procedure Candidacy:

Patients with MELD scores > 18 to 20 face significantly elevated post-TIPS mortality risk due to severe hepatic synthetic dysfunction, requiring careful procedural risk-benefit stratification before portal decompression intervention.

Living Donor Liver Transplantation (LDLT)

In regions with severe deceased donor liver organ shortages, Living Donor Liver Transplantation (LDLT) provides an alternative pathway:

Healthy adult donors donate 55% to 65% of their right hepatic lobe, which regenerates to full functional liver volume within 8 to 12 weeks in both the donor and recipient, bypassing MELD-based UNOS waitlist prioritization.

Palliative Care Considerations in High MELD Scores

For patients with MELD scores exceeding 35 who are deemed too medically complex for transplant candidacy, hepatology teams initiate comprehensive Palliative Care and Comfort-Focused Management, addressing refractory ascites, hepatic encephalopathy, variceal hemorrhage, and quality-of-life symptom optimization.

Serial MELD Score Monitoring

Hepatology teams monitor sequential MELD scores at regular intervals to detect trajectories of hepatic decompensation: rising MELD scores trigger expedited transplant evaluation referral while stable or declining scores may indicate successful medical management of the underlying liver disease.

Accurate MELD scoring remains the definitive tool guiding liver transplant allocation and clinical hepatology decision-making worldwide.