Units: Conventional Standard

Model for End-Stage Liver Disease (MELD)

Serum Bilirubin mg/dL
INR
Serum Creatinine mg/dL
Has the patient had dialysis at least twice in the past week? Yes
MELD Score points  

MELD Score = (0.957 * ln(Serum Cr) + 0.378 * ln(Serum Bilirubin) + 1.120 * ln(INR) + 0.643 ) * 10 (if hemodialysis, value for Creatinine is automatically set to 4.0)

The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease. This score is now used by the United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score.

Scores range from 6-40. A score of six indicates the least ill patient and a score of forty indicates the sickest patient. MELD scores go up and down depending upon the patient's health.

It was initially developed to predict death within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. Patients with a diagnosis of liver cancer will be assigned a MELD score based on how advanced the cancer is.

In interpreting the MELD Score in hospitalized patients, the 3 month mortality is:

  • 40 or more -- 71.3% mortality
  • 30-39 -- 52.6% mortality
  • 20-29 -- 19.6% mortality
  • 10-19 -- 6.0% mortality
  • <9 -- 1.9% mortality

A major limitation of MELD score is the need for computation, which makes it less friendly to use than Child-Pugh score at the bedside.

Reference:

Malinchoc M et al: A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts: Hepatology 2000 ; 31 (4): 864-71

Disclaimer:
The calculators allow you to enter patient specific information to calculate a simple score. All information is provided for educational purposes only. This information is not intended to replace clinical judgement. All calculations must be rechecked and should not be used alone to guide patient care. The user assumes sole responsibility for any decisions or action taken based on the information contained here.