MELD Score
Model for End-stage Liver Disease. Predicts 3-month mortality. Used for liver transplant prioritisation.
How to use & interpret
MELD predicts short-term (90-day) mortality in chronic liver disease and is used to prioritise liver transplantation. It is calculated from bilirubin, INR and creatinine; MELD-Na and MELD 3.0 add sodium (and, in 3.0, albumin and sex) for better discrimination.
Higher scores mean higher mortality and greater transplant priority; a MELD around 15 is often the threshold at which transplant survival benefit emerges. MELD is also used to estimate peri-operative risk in cirrhosis. It is not validated in acute liver failure.
Score interpretation
MELD ≤9: 3-month mortality ~2%.
→ Continue close hepatology follow-up. 6-monthly HCC surveillance.
MELD 10–19: 3-month mortality 6–20%.
→ Hepatology review. Manage complications. Consider transplant assessment if appropriate.
MELD 20–29: 3-month mortality ~20%.
→ Liver transplant listing consideration. Urgent hepatology management.
MELD 30–39: 3-month mortality ~40–50%.
→ Priority liver transplant listing. ITU/HDU if decompensating.
MELD ≥40: 3-month mortality ~70%.
→ Super-urgent transplant listing. Intensive care. Discuss prognosis.
Interpretation bands for the MELD. Apply clinical judgement and local guidance.
Frequently asked questions
What is the difference between MELD, MELD-Na and MELD 3.0?
MELD-Na incorporates sodium (hyponatraemia worsens prognosis); MELD 3.0 further adds albumin and sex and updates the coefficients. Most UK/US allocation now uses a sodium-containing version.
References
- Kamath PS et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001.
- Malinchoc M et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000.
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.