What MELD-Na measures
MELD (Model for End-Stage Liver Disease) uses bilirubin, INR, and creatinine to estimate short-term mortality risk in patients with cirrhosis. MELD-Na adds serum sodium, since hyponatremia independently predicts mortality in liver disease and improves the score's accuracy — it has been the standard for liver transplant allocation in the US since 2016.
How it's used
- <15: Transplant generally not prioritized — surgical risk often outweighs benefit
- 15–24: Transplant evaluation typically indicated
- ≥25: High short-term mortality risk
This calculator doesn't include MELD exception points (e.g. for hepatocellular carcinoma), which are determined separately through formal transplant review.
Lab value bounds
Per the standard formula, bilirubin, INR, and creatinine are each floored at 1.0 if measured lower. Creatinine is capped at 4.0 mg/dL (and set to 4.0 automatically if the patient is on dialysis). Sodium is bounded between 125–137 mEq/L for the MELD-Na adjustment.
MELD-Na vs. Child-Pugh
The Child-Pugh score is an older, partly subjective alternative (it includes clinical assessment of ascites and encephalopathy) that's still useful for general prognosis and estimating surgical risk. MELD-Na is lab-based only, which makes it more objective and is why it's used for transplant allocation.