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MELD Score Calculator

Estimate liver disease severity with the MELD score.

How it is calculated

The classic MELD formula combines three blood tests: raw = 3.78 × ln(bilirubin) + 11.2 × ln(INR) + 9.57 × ln(creatinine) + 6.43. Bilirubin and creatinine are in mg/dL and INR is unitless. Before the calculation each value below 1.0 is raised to 1.0 and creatinine is capped at 4.0. The raw number is rounded to a whole score and kept between 6 and 40. All three values must be above zero. This version does not add sodium, so it is not MELD-Na, and it does not use the dialysis rule. It is for information and understanding only; a score is interpreted by a clinician together with the whole clinical picture.

Worked example

Bilirubin 3.2 mg/dL, INR 1.8, creatinine 1.4 mg/dL. Natural logs: ln 3.2 = 1.163, ln 1.8 = 0.588, ln 1.4 = 0.336. Terms: 3.78 × 1.163 = 4.40; 11.2 × 0.588 = 6.58; 9.57 × 0.336 = 3.22. Sum with 6.43: raw = 20.63. Rounded and clamped to the 6 to 40 range, the MELD score is 21 (raw value 20.63).

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Common mistakes

  • Entering bilirubin or creatinine in µmol/L. The fields use mg/dL; divide bilirubin by about 17.1 and creatinine by about 88.4 to convert.
  • Entering INR as a percentage prothrombin activity rather than the INR ratio.
  • Expecting values below 1.0 to lower the score; they are treated as 1.0.
  • Reading this as MELD-Na or as a prediction for an individual. This version has no sodium term and cannot replace a transplant-centre calculation.
  • Using old lab results. The score changes as the blood tests change.

Sources

About this calculator

This calculator computes the MELD (Model for End-Stage Liver Disease) score from three lab values — serum bilirubin, INR, and serum creatinine — using the standard logarithmic formula: MELD = 3.78×ln(bilirubin) + 11.2×ln(INR) + 9.57×ln(creatinine) + 6.43, with values floored at 1.0 to keep logarithms defined.

Hepatologists, transplant coordinators, and nurses use the MELD score to gauge the severity of chronic liver disease and, most notably, to prioritize patients on liver transplant waiting lists, since the score correlates strongly with 90-day mortality risk.

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Comments (1)

  • Editorial team

    Because values under 1.0 are raised to 1.0, even normal labs give the minimum score of 6, so a low MELD only says the three tests are not strongly abnormal. Newer versions of the score, such as MELD 3.0, add sodium, albumin and sex, so a transplant centre's figure can differ from this classic one. Treat the result as background, and discuss it with the treating team. Which unit system are your lab reports in?

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