MELD 3.0 Calculator – Liver Disease Severity and Transplant Priority

Clinical calculation support · Verify results before clinical use

Clinical Parameters

Enter the patient's demographic and laboratory values. All laboratory values should be from the same clinical assessment.

—MELD 3.0

Patient Information

Age at registration (years) Enter age at transplant-list registration; this implementation is for candidates registered at age 18 years or older.

Sex for adult MELD calculation

Male

Female

Female sex contributes 1.33 points in the adult equation.

Laboratory Values

Total bilirubin (mg/dL) Values below 1.0 mg/dL are entered into the equation as 1.0.

INR Values below 1.0 are entered into the equation as 1.0.

Serum creatinine (mg/dL) The calculation value is capped at 3.0 mg/dL.

Serum sodium (mmol/L) The calculation range is 125–137 mmol/L.

Serum albumin (g/dL) The calculation range is 1.5–3.5 g/dL.

Dialysis criterion met: at least two dialysis treatments within the 7 days before the serum creatinine test, or 24 hours of CVVHD within the preceding 7 days. When selected, creatinine is set to 3.0 mg/dL for this calculation, consistent with OPTN adult MELD policy.

—Score

Calculated adult MELD 3.0 score

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Calculation values after policy limits

About MELD 3.0

MELD 3.0 (Model for End-Stage Liver Disease 3.0) is an updated prognostic model developed to estimate short-term mortality risk among adult candidates awaiting liver transplantation. It incorporates serum bilirubin, INR, creatinine, sodium, albumin, and sex.

In the United States, OPTN policy uses MELD for liver allocation priority in candidates aged 12 years and older; the adult equation shown here applies to candidates aged 18 years or older at registration. This standalone calculator is an educational estimate and does not determine a candidate's official allocation score.

Variables and calculation limits

Bilirubin, INR, and creatinine values below 1.0 are set to 1.0.
Creatinine is capped at 3.0 mg/dL; qualifying recent dialysis also sets it to 3.0 mg/dL.
Sodium is bounded between 125 and 137 mmol/L.
Albumin is bounded between 1.5 and 3.5 g/dL.
The final score is rounded to the nearest integer and bounded from 6 to 40.

Equation

MELD 3.0 = 1.33 (if female) + 4.56 × ln(bilirubin) + 0.82 × (137 − sodium) − 0.24 × (137 − sodium) × ln(bilirubin) + 9.09 × ln(INR) + 11.14 × ln(creatinine) + 1.85 × (3.5 − albumin) − 1.83 × (3.5 − albumin) × ln(creatinine) + 6.

All laboratory values are substituted after applying the limits above. ln = natural logarithm.

Clinical interpretation

Higher MELD 3.0 scores indicate greater estimated short-term waitlist mortality risk and generally greater urgency for transplant allocation. The score is a prioritization tool, not a diagnosis, a direct measure of liver function, or a standalone recommendation for transplantation.

References

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;161(6):1887–1895.e4. DOI: 10.1053/j.gastro.2021.08.050.

Organ Procurement and Transplantation Network (OPTN), Health Resources and Services Administration. OPTN Policy 9.1.D, MELD Score; adult candidate calculation and laboratory value limits. Official policy notice: Improving Liver Allocation: MELD, PELD, Status 1A, Status 1B. Adult MELD 3.0 implementation effective July 13, 2023.

Health Resources and Services Administration (HRSA) / OPTN. MELD Calculator. Official description of allocation use and required inputs. Official OPTN calculator information. Last reviewed December 2025.

Clinical disclaimer: This calculator is intended for educational and clinical reference use. It calculates an estimated adult MELD 3.0 score from user-entered values and does not reproduce every OPTN allocation rule, exception, status assignment, recertification requirement, or transplant-center workflow. Confirm all values, units, timing, eligibility, and the official score with the relevant transplant program and current OPTN policy. Do not use this result as the sole basis for clinical decisions.