{
  "slug": "meld-score",
  "title": "MELD-Na Score Calculator",
  "heading": "MELD-Na Score Calculator",
  "category": "fitness-health",
  "url": "https://www.revenuelab.fyi/toolbox/meld-score",
  "summary": "Model for End-Stage Liver Disease score used for transplant priority.",
  "description": "MELD-Na (Model for End-Stage Liver Disease, sodium-adjusted) estimates three-month mortality in patients with end-stage liver disease and is the primary score used by transplant allocation systems in the US to prioritize deceased-donor liver transplant candidates — higher scores get higher priority because they reflect more urgent need. It's calculated from bilirubin, creatinine, INR, and sodium, with all lab values floored at 1.0 (or 1) and creatinine capped at 4.0 mg/dL (and set to 4.0 if the patient has had two or more dialysis sessions in the past week) to prevent extreme lab values from producing unrealistic scores. Sodium is capped between 125 and 137 mEq/L in the calculation. The score ranges from 6 to 40, with scores above 30-35 indicating extremely high short-term mortality risk. This calculator reproduces the standard formula for general understanding of transplant priority scoring — actual UNOS/OPTN allocation calculations, exception points, and listing decisions must go through the official transplant center and registry process, not this tool. This tool is for education and workflow support only — not medical advice. Always verify results with a clinician and use clinical judgment alongside your institution's protocols.",
  "formula": "MELD-Na = MELD + 1.32×(137−Na) − [0.033×MELD×(137−Na)], where MELD = 3.78×ln(bili) + 11.2×ln(INR) + 9.57×ln(creatinine) + 6.43.",
  "dateModified": "2026-09-30",
  "run_url": "https://www.revenuelab.fyi/api/public/calc?tool=meld-score",
  "inputs": [
    {
      "id": "bilirubin",
      "label": "Total bilirubin",
      "kind": "number",
      "hint": null,
      "default": 3.2,
      "unit": "mg/dL",
      "min": 0.1,
      "max": 50
    },
    {
      "id": "creatinine",
      "label": "Creatinine",
      "kind": "number",
      "hint": null,
      "default": 1.8,
      "unit": "mg/dL",
      "min": 0.1,
      "max": 20
    },
    {
      "id": "inr",
      "label": "INR",
      "kind": "number",
      "hint": null,
      "default": 1.9,
      "unit": null,
      "min": 0.8,
      "max": 10
    },
    {
      "id": "sodium",
      "label": "Sodium",
      "kind": "number",
      "hint": null,
      "default": 132,
      "unit": "mEq/L",
      "min": 100,
      "max": 150
    },
    {
      "id": "dialysis",
      "label": "Dialysis ≥2x in past week",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    }
  ],
  "outputs": [
    {
      "id": "finalScore",
      "label": "MELD-Na score",
      "format": "number",
      "hint": null,
      "primary": true
    },
    {
      "id": "meldBase",
      "label": "Base MELD (no sodium)",
      "format": "number",
      "hint": null,
      "primary": false
    },
    {
      "id": "mortality",
      "label": "Approx. 3-month mortality risk",
      "format": "raw",
      "hint": null,
      "primary": false
    }
  ],
  "worked_example": {
    "inputs": [
      "Total bilirubin: 3.2 mg/dL",
      "Creatinine: 1.8 mg/dL",
      "INR: 1.9",
      "Sodium: 132 mEq/L",
      "Dialysis ≥2x in past week: No"
    ],
    "outputs": [
      "MELD-Na score: 27",
      "Base MELD (no sodium): 24",
      "Approx. 3-month mortality risk: High 3-month mortality (~20-50%)"
    ]
  },
  "how_to": {
    "title": "How to use this",
    "steps": [
      "Enter total bilirubin (mg/dL).",
      "Enter creatinine (mg/dL).",
      "Enter inr.",
      "Enter sodium (mEq/L).",
      "Enter dialysis ≥2x in past week.",
      "Read your meld-na score on the right — it updates as you type.",
      "Hit Share to keep the scenario or send it to someone."
    ]
  },
  "scenarios": [
    {
      "name": "Conservative",
      "description": "Lower-end numbers — what if things land soft?",
      "values": {
        "bilirubin": 1.92,
        "creatinine": 1.08,
        "inr": 1.14,
        "sodium": 100,
        "dialysis": "no"
      }
    },
    {
      "name": "Typical",
      "description": "Defaults — the most common real-world setup.",
      "values": {
        "bilirubin": 3.2,
        "creatinine": 1.8,
        "inr": 1.9,
        "sodium": 132,
        "dialysis": "no"
      }
    },
    {
      "name": "Ambitious",
      "description": "Higher-end numbers — what if things really pop?",
      "values": {
        "bilirubin": 5.120000000000001,
        "creatinine": 2.8800000000000003,
        "inr": 3.04,
        "sodium": 150,
        "dialysis": "no"
      }
    }
  ],
  "limitations": [
    "Population formulas describe averages; individual bodies vary, especially at the extremes of height, age, or muscle mass.",
    "Results do not account for medical conditions, medication, or pregnancy.",
    "Use this as a directional reference, not a diagnosis — talk to a clinician before acting on it."
  ],
  "faq": [
    {
      "q": "Why does MELD-Na cap creatinine at 4.0?",
      "a": "Without a cap, extremely high creatinine values (common in dialysis-dependent patients) would push the score disproportionately high in a way that doesn't track additional real mortality risk, so the formula caps creatinine at 4.0 mg/dL, and automatically uses 4.0 for anyone who has had two or more dialysis sessions in the preceding week regardless of measured creatinine."
    },
    {
      "q": "Why was sodium added to the original MELD score?",
      "a": "Studies found that hyponatremia independently predicted mortality in cirrhosis beyond what bilirubin, INR, and creatinine captured alone, particularly in patients with lower MELD scores where sodium had the most discriminating power. Adding sodium (MELD-Na) improved prediction accuracy and it has been the standard formula used for U.S. liver allocation since 2016."
    },
    {
      "q": "Can I use this calculator for actual transplant listing?",
      "a": "No. This reproduces the public MELD-Na formula for educational purposes, but actual UNOS/OPTN allocation involves exception points, policy-specific rounding and rules, and periodic formula updates that must be run through the official transplant center and registry systems, not a general calculator."
    },
    {
      "q": "What MELD-Na score is considered for transplant listing?",
      "a": "Practices vary by center and region, but scores in the high teens to 20s are commonly where formal transplant evaluation intensifies, and allocation priority increases meaningfully as the score climbs into the 25-30+ range, reflecting rapidly rising 90-day mortality without transplant."
    }
  ],
  "related": [
    "https://www.revenuelab.fyi/toolbox/child-pugh-score",
    "https://www.revenuelab.fyi/toolbox/creatinine-clearance-cockcroft-gault",
    "https://www.revenuelab.fyi/toolbox/fena-calculator"
  ],
  "license": "CC-BY-4.0",
  "citation": "RevenueLab — MELD-Na Score Calculator (https://www.revenuelab.fyi/toolbox/meld-score)"
}