The Cardiovascular
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MELD score (original, pre-2016)

Original UNOS Model for End-Stage Liver Disease without sodium.

MELD score (original, pre-2016)
Creatinine
mg/dL
Bilirubin (total)
mg/dL
INR
INR
Dialysis >=2 times in the past 7 days (or 24 h CVVHD)
Complete the fields above to see the result.

When to use

  • Prognosis in chronic liver disease and historic transplant allocation before the 2016 sodium update.

Formula

MELD = 9.57*ln(Cr) + 3.78*ln(bilirubin) + 11.2*ln(INR) + 6.43. Labs <1.0 set to 1.0; creatinine capped at 4.0 (set to 4.0 if dialysed >=2x/week). Rounded, range 6-40.

Pearls and pitfalls

  • This UNOS modification omits the original disease-aetiology term.
  • Any laboratory value below 1.0 is rounded up to 1.0 to avoid negative logarithms.

References

  1. Kamath PS, et al. Hepatology. 2001;33(2):464-70.
  2. Wiesner R, et al. Gastroenterology. 2003;124(1):91-6.