MELD 3.0 Score Calculator

MELD 3.0 is the current model the United Network for Organ Sharing (UNOS) and the Organ Procurement and Transplantation Network (OPTN) use to rank adult candidates for liver transplantation. It refined the earlier MELD and MELD-Na models by adding female sex and serum albumin, two interaction terms, and a lower creatinine cap. The calculation has two stages: bound the inputs, then evaluate the equation.

1. Apply the variable bounds (OPTN policy)

• Bilirubin, INR and creatinine below 1.0 are raised to 1.0.
• Creatinine above 3.0 is capped at 3.0 mg/dL. If the candidate had dialysis at least twice in the last 7 days (or 24h CVVHD), creatinine is set to 3.0.
• Serum sodium is bounded to 125–137 mmol/L.
• Serum albumin is bounded to 1.5–3.5 g/dL.

2. Evaluate the MELD 3.0 equation

With female = 1 for women and 0 for men, and ln the natural logarithm, the score is the sum of these weighted terms:

MELD 3.0 = 1.33 × female
         + 4.56 × ln(bilirubin)
         + 0.82 × (137 − Na)
         − 0.24 × (137 − Na) × ln(bilirubin)
         + 9.09 × ln(INR)
         + 11.14 × ln(creatinine)
         + 1.85 × (3.5 − albumin)
         − 1.83 × (3.5 − albumin) × ln(creatinine)
         + 6

The result is rounded to the nearest whole number and clamped to 6–40. Every coefficient here is transcribed from Kim WR and colleagues' 2021 derivation and the OPTN allocation policy. The calculator evaluates the equation two ways — as a labelled sum of terms and as a single flat expression — so a mis-typed coefficient would show up immediately; both paths agree to the decimal, and the two worked examples below reproduce MDCalc's MELD 3.0 output exactly.

The score is monotonic: higher means worse liver function and higher predicted short-term mortality, which is why a higher MELD carries higher transplant priority. The 3-month mortality figures shown are the original MELD reference bands (Wiesner and Kamath), included for orientation rather than as a MELD 3.0-specific prediction.

The reference 3-month mortality for each MELD band, from the original MELD survival study. Treat these as orientation, not a patient-specific prognosis:

• OPTN / UNOS — liver allocation policy (MELD 3.0, effective 2023)
• Kim WR, et al. MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era. Gastroenterology 2021;161(6):1887–1895
• Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001;33(2):464–470

Coefficients, variable bounds, the dialysis rule and the 6/40 caps were last cross-checked against the OPTN policy and Kim WR et al. (2021) on 2026-07-13, and the two worked examples were verified against MDCalc's MELD 3.0 calculator. This page is reviewed whenever OPTN revises the allocation policy.