The Cardiovascular
ToolsCalculators

MELD-Na score

Prognosis and transplant priority in end-stage liver disease.

MELD-Na score
Bilirubin
mg/dL
INR
INR
Creatinine
mg/dL
Sodium
mEq/L
Dialysis ≥twice in past week
Complete the fields above to see the result.

When to use

  • Prognosis in chronic liver disease and prioritisation for liver transplantation (UNOS uses MELD-Na for candidates ≥12 years).

Formula

MELD = 10 × [0.957·ln(Cr) + 0.378·ln(bilirubin) + 1.120·ln(INR) + 0.643], labs floored at 1.0, Cr capped at 4.0 (or 4.0 if dialysed ≥2×/week). If MELD >11: MELD-Na = MELD + 1.32·(137 − Na) − [0.033·MELD·(137 − Na)], Na bounded 125–137. Reported 6–40.

Pearls and pitfalls

  • Bounding creatinine at 4.0 and flooring all labs at 1.0 is part of the definition — skipping it inflates or deflates the score.

References

  1. Kim WR, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018–26.