MELD Score

The Model for End-Stage Liver Disease (MELD) is a scoring system for assessing the severity of chronic liver disease. MELD was initially developed to predict death within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure. Subsequent studies demonstrated its usefulness in determining the prognosis of groups of patients with chronic liver disease. MELD score has been shown useful both in predicting short-term survival in groups of patients on the waiting list for liver transplantation as well as the risk of postoperative mortality. The United Network for Organ Sharing (UNOS) and Eurotransplant now use MELD score for prioritizing allocation of liver transplants.

MELD uses three laboratory values to predict survival; serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR). It is calculated according to the following formula:

MELD = 3.78[Ln serum bilirubin (mg/dL)] + 11.2[Ln INR] + 9.57[Ln serum creatinine (mg/dL)] + 6.43

An on-line calculator is available at:

UNOS has made the following modifications to the original MELD score:

  • If the patient has been dialyzed twice within the last 7 days, then serum creatinine should be assigned a value of 4.0
  • Any value less than one should be converted to 1.0 (e.g. if bilirubin is 0.9, a value of 1.0 is used). The reason for this conversion is that the natural logarithm of 1 is 0, and any value below 1 would yield a negative result.

Using the MELD score, patients are assigned a score from 6 to 40, which equates to an estimated 3-month survival rate from 90% to 7%, respectively.

MELD Score

3 Month Mortality

40 or more

71.3% mortality


52.6% mortality


19.6% mortality


6.0% mortality


1.9% mortality

Patients with MELD scores 17 or greater are considered candidates for liver transplantation. Patients with scores <15 are deferred.

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