The Cardiovascular
ToolsCalculators

MELD Na (UNOS/OPTN)

Sodium-adjusted MELD used for US liver-transplant allocation since 2016.

MELD Na (UNOS/OPTN)
Creatinine
mg/dL
Bilirubin (total)
mg/dL
INR
INR
Sodium
mEq/L
Dialysis >=2 times in the past 7 days (or 24 h CVVHD)
Complete the fields above to see the result.

When to use

  • US deceased-donor liver-transplant allocation and prognosis in patients >=12 years (2016 policy).

Formula

MELD(i) = round[10 x (0.957*ln(Cr) + 0.378*ln(bili) + 1.120*ln(INR) + 0.643)] with labs floored at 1.0 and Cr capped at 4.0 (set to 4.0 if dialysed >=2x/week). If MELD(i) >11: MELD-Na = MELD(i) + 1.32*(137 - Na) - 0.033*MELD(i)*(137 - Na), with Na bounded 125-137. Final capped at 40.

Pearls and pitfalls

  • Sodium correction is applied only when MELD(i) exceeds 11.
  • Coefficients 9.57/3.78/11.2/6.43 equal the OPTN 0.957/0.378/1.120/0.643 values times 10.

References

  1. Kim WR, et al. N Engl J Med. 2008;359(10):1018-26.
  2. OPTN Policy 9: MELD/PELD allocation (implemented January 2016).