Calculator Guides
Understanding the MELD Score: A Complete Guide
Learn how to interpret and apply the MELD score for liver disease severity assessment and transplant prioritization.
The Model for End-Stage Liver Disease (MELD) score is a numerical scale used to assess the severity of chronic liver disease. It was initially developed to predict survival in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) procedures but is now widely used for liver transplant allocation.
How MELD is Calculated
The MELD score uses three laboratory values:
- Serum bilirubin - measures liver's ability to excrete bile
- Serum creatinine - assesses kidney function
- INR (International Normalized Ratio) - evaluates the liver's clotting factor production
Clinical Applications
- Transplant Prioritization: Higher MELD scores indicate greater disease severity and higher priority for transplantation
- Mortality Prediction: Estimates 90-day mortality risk in patients with cirrhosis
- Surgical Risk Assessment: Helps evaluate perioperative risk in patients with liver disease
Interpreting the Score
| MELD Score | 3-Month Mortality |
|---|---|
| < 9 | 1.9% |
| 10-19 | 6% |
| 20-29 | 19.6% |
| 30-39 | 52.6% |
| ≥ 40 | 71.3% |
Key Considerations
- MELD does not account for complications like hepatic encephalopathy or ascites
- Exception points may be granted for specific conditions (e.g., hepatocellular carcinoma)
- MELD-Na includes sodium levels and may provide improved accuracy
Related calculators
- MELD Score Calculator - Gastroenterology
- MELD-Na Score Calculator - Gastroenterology