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gi-hepatology

MELD 3.0 Score

MELD 3.0 — updated MELD incorporating sex-specific factor and albumin. Improves survival prediction in women and those with low albumin. Replaces MELD-Na for organ allocation in some centres.

Score interpretation

Low — 90-day Mortality <2%

→ MELD 3.0 <10: Very low 90-day mortality risk. Continue medical management; review for optimisation of complications (ascites, HE, varices). Not a transplant priority.

Moderate — 90-day Mortality 6–20%

→ MELD 3.0 10–19: Moderate disease severity. Liver transplant listing evaluation; treat complications aggressively; hepatology review monthly; SBP prophylaxis; beta-blockers for varices.

High — 90-day Mortality 20–50%

→ MELD 3.0 20–29: High mortality risk. Priority liver transplant listing; TIPS consideration for refractory ascites/varices; nephrology involvement for HRS; close follow-up.

Very High — 90-day Mortality >50%

→ MELD 3.0 ≥30: Very high mortality risk. Urgent liver transplant evaluation; intensive care if AKI/HRS; palliative care discussion if not transplant candidate; goals of care.

Interpretation bands for the MELD 3.0. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.