A tool to support the clinical decisions of doctors and health professionals, not for self-diagnosis or self-treatment.
This calculator is inside the patient's file in Clinicato: open it from "Medical tools" while you chart the visit, it fills in from the patient's details and vital signs where they are recorded, and adds its result to the visit's plan in one tap, with the "Medical tools" add-on. Try it in your clinic
Calculator
How it works and when to use it
MELD comes from creatinine, bilirubin and INR: 0.957 × ln(creatinine) + 0.378 × ln(bilirubin) + 1.120 × ln(INR) + 0.643, rounded to one decimal and multiplied by 10.
Following the OPTN policy, any value under 1.0 counts as 1.0, creatinine is capped at 4.0 and set to 4.0 after dialysis twice in the past week, sodium is bounded to 125-137, and above 11 sodium is added: MELD + 1.32 × (137 - Na) - 0.033 × MELD × (137 - Na), with a maximum of 40.
Since July 2023 the US organ allocation system uses MELD 3.0, which adds albumin and sex, while MELD-Na is still widely used in assessment and research.
Reference: Kamath PS et al. Hepatology 2001;33:464-70 (MELD); Kim WR et al. N Engl J Med 2008;359:1018-26 (MELD-Na); OPTN Policy 9.1.D, MELD score calculation with its bounds (2016); since July 2023 OPTN allocates with MELD 3.0 (Kim WR et al. Gastroenterology 2021;161:1887-95)
Frequently asked questions
Why is the score never below 6?
Values under 1.0 count as 1.0, whose logarithm is zero, leaving the constant 0.643 × 10, that is 6.
Is MELD used in children?
No, PELD is used under 12 years of age.
How does MELD differ from Child-Pugh?
MELD uses laboratory values only and was built to predict short-term mortality, Child-Pugh combines laboratory values with clinical signs such as ascites and encephalopathy.
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Clinic software for this specialty
Try Clinicato for your clinic
These calculators are free here for everyone, and in Clinicato 49 medical tools work inside the patient's file with the "Medical tools" add-on: filled from the visit and the vital signs, with the result added to the visit's plan, next to appointments, prescriptions and invoices.