MELD-Na Score Calculator (Liver Allocation)

MELD-Na = MELD + 1.32 × (137 − Na) − [0.033 × MELD × (137 − Na)]. UNOS 2016 update; Kim 2008 NEJM.

Inputs

Cap at 4.0; if dialysis ×2 in past wk → use 4.0.

Result

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How to use this calculator

  • Enter creatinine, bilirubin, INR, sodium.
  • Indicate if patient has been on HD ≥2× in past week.
  • Read MELD-Na — UNOS uses this for transplant priority (higher = sicker, higher priority).

About this calculator

MELD-Na (Model for End-Stage Liver Disease with Sodium) is the score used by UNOS for liver-transplant allocation in the US since 2016. Original MELD (Kamath PS et al., Hepatology 2001) used creatinine/bilirubin/INR; sodium added (Kim WR et al., NEJM 2008;359:1018) because hyponatremia independently predicts mortality. Per OPTN/UNOS: bound creatinine, bilirubin, INR ≥ 1.0; cap creatinine at 4.0 (or set to 4.0 if HD ≥ 2× in 7 days); bound Na to [125, 137]; cap final MELD-Na at 40. **Not medical advice — transplant decisions involve much more than this score.**

Frequently asked

Source of the formula?+
Kim WR et al., "Hyponatremia and mortality among patients on the liver-transplant waiting list." NEJM 2008;359(10):1018-26. Adopted by UNOS for allocation in January 2016.
Why bound the inputs?+
Below 1.0, ln becomes negative and inflates score artificially. Above creatinine 4.0, the score saturates — values aren't additive predictive past renal failure.
When is MELD-Na = MELD?+
When MELD ≤ 11 OR Na = 137. UNOS only applies the Na correction if MELD > 11.
MELD vs. MELD-Na vs. MELD 3.0?+
Original MELD: 2001. MELD-Na: 2016 UNOS. MELD 3.0 (Kim WR, Gastroenterology 2021;161:1887): adds sex + albumin + adjusts terms. UNOS adopted MELD 3.0 in July 2023.
3-month mortality bands?+
≤9: ~1.9%; 10-19: ~6%; 20-29: ~19.6%; 30-39: ~52.6%; ≥40: ~71.3% (Wiesner R et al., Gastroenterology 2003;124:91; original MELD validation).
Is this medical advice?+
No. UNOS allocation involves exception points (HCC, refractory ascites, etc.), MELD 3.0 (current), and individualized assessment.

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