MELD 3.0 Score Calculator
Calculates the Model for End-Stage Liver Disease (MELD) 3.0 score to assess severity of chronic liver disease and prioritize organ allocation for liver transplantation.
Patient Laboratory Values
MELD 3.0 includes sex as a variable to address allocation disparities
Values less than 1.0 will be set to 1.0 for calculation
Will be capped between 125-137 mEq/L for calculation
Values less than 1.0 will be set to 1.0 for calculation
Capped at 3.0 mg/dL. Set to 3.0 if on dialysis
Will be capped between 1.5-3.5 g/dL for calculation
If yes, creatinine will be set to 3.0 mg/dL
MELD 3.0 Value Bounds
MELD 3.0 Score
Enter values to calculate
About This Calculator
The MELD 3.0 Score is the latest iteration of the Model for End-Stage Liver Disease, updated in 2024 to address disparities in the original MELD and MELD-Na scores. It is used to assess the severity of chronic liver disease and predict 90-day mortality in patients awaiting liver transplantation.
MELD 3.0 incorporates sex as a variable to address the documented disadvantage female patients had under previous MELD scores. It also includes serum albumin as a new predictor, improving mortality prediction accuracy.
The score is used by UNOS (United Network for Organ Sharing) for liver transplant allocation in the United States. Higher scores indicate more severe liver disease and higher priority for transplantation.
Formula
MELD 3.0 = 1.33 × (female) + 4.56 × ln(Bilirubin) + 0.82 × (137 - Na) − 0.24 × (137 - Na) × ln(Bilirubin) + 9.09 × ln(INR) + 11.14 × ln(Creatinine) + 1.85 × (3.5 − Albumin) − 1.83 × (3.5 − Albumin) × ln(Creatinine) + 6The MELD 3.0 formula incorporates: • Sex coefficient: +1.33 points if female (addresses historic sex-based disparity) • Bilirubin: Reflects liver's ability to excrete bile • Sodium: Hyponatremia correlates with portal hypertension severity • INR: Measures liver synthetic function (coagulation factors) • Creatinine: Reflects kidney function (hepatorenal syndrome) • Albumin: Reflects liver synthetic function (NEW in MELD 3.0) Values are bounded: Na (125-137), Albumin (1.5-3.5), Creatinine (≤3.0), and values <1 are set to 1 before taking logarithm.
Clinical Considerations
- •MELD 3.0 should not be used to predict post-transplant survival
- •Does not apply to patients under 12 years old (use PELD instead)
- •May underestimate mortality in certain conditions (e.g., hepatocellular carcinoma, hepatopulmonary syndrome)
- •Exception points may be needed for conditions not reflected in laboratory values
- •Score should be recalculated with current lab values at each assessment
Limitations
- •Based on 90-day waitlist mortality, not post-transplant outcomes
- •Does not account for hepatocellular carcinoma tumor burden
- •May not accurately predict mortality in acute liver failure
- •Regional variations in organ availability affect practical implications
- •Some conditions warrant exception points beyond calculated MELD
Interpretation Guide
| Range | Classification | Recommendation |
|---|---|---|
| <-10 | Low Mortality Risk | Low short-term mortality risk. Continue medical management and monitoring. Evaluate for underlying etiology and treat reversible causes. |
| 10-20 | Moderate Mortality Risk | Moderate risk. Consider transplant evaluation if not already initiated. Optimize medical management and address complications. |
| 20-30 | High Mortality Risk | High mortality risk. Urgent transplant evaluation recommended. Intensive monitoring and management of complications required. |
| 30-40 | Very High Mortality Risk | Very high mortality risk. Expedited transplant evaluation and listing. Consider status exception applications if appropriate. |
| 40-100 | Critical Mortality Risk | Critical mortality risk. Maximum priority for transplantation. Intensive care management. Consider palliative care discussions if not transplant candidate. |
Frequently Asked Questions
What is the MELD 3.0 score?
MELD 3.0 is the latest version of the Model for End-Stage Liver Disease score, implemented in 2024. It predicts 90-day mortality in patients with chronic liver disease and is used by UNOS to prioritize liver transplant allocation. MELD 3.0 includes sex and albumin as new variables to improve accuracy and equity.
How is MELD 3.0 different from previous MELD scores?
MELD 3.0 adds sex as a variable (+1.33 points for females) to address the documented disadvantage women had under previous scoring systems. It also incorporates serum albumin, which improves mortality prediction. These changes result in more equitable organ allocation.
What MELD score is needed for liver transplant?
There is no specific MELD score threshold for transplant eligibility. However, patients with MELD ≥15 generally have survival benefit from transplantation. Organ allocation prioritizes higher MELD scores. The actual score needed depends on regional organ availability and wait times.
How often should MELD be recalculated?
MELD scores should be recalculated with each new set of laboratory values. For transplant listing purposes, the frequency depends on the score: every 7 days for MELD ≥25, every 30 days for MELD 19-24, and every 90 days for MELD ≤18.
What are MELD exception points?
Exception points are additional points added to the calculated MELD score for conditions that increase mortality but are not reflected in lab values. Common exceptions include hepatocellular carcinoma (HCC), hepatopulmonary syndrome, and portopulmonary hypertension.
References
1. Kim WR, Mannalithara A, Heimbach JK, et al.. MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era. Gastroenterology. 2021. doi: 10.1053/j.gastro.2021.08.050
View Source →2. Organ Procurement and Transplantation Network. OPTN/UNOS Liver and Intestinal Organ Transplantation Committee Policy Update. OPTN Policy. 2024
View Source →3. Malinchoc M, Kamath PS, Gordon FD, et al.. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000. doi: 10.1053/jhep.2000.5852
View Source →Last updated: 2025-01-15
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