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gi-hepatology

MELD-Na Score for Liver Cirrhosis

MELD-Na (UNOS/OPTN) incorporates serum sodium into the standard MELD score. Currently used by UNOS for liver transplant organ allocation in the United States. Improves prediction over MELD alone.

Used in: Liver Disease & Cirrhosis Hyponatraemia

Score interpretation

Low Priority — <10% 90-day Mortality

→ MELD-Na <15: Low transplant priority. Optimise complications; TIPS if appropriate; monthly hepatology review; sodium correction (fluid restriction if dilutional).

Transplant Listing Priority

→ MELD-Na 15–24: Active transplant list priority. Monitor every 1–3 months; aggressively treat complications; dietitian input; alcohol abstinence; consider TIPS for refractory ascites.

High Transplant Priority

→ MELD-Na 25–34: High transplant priority. Intensify transplant evaluation; hospitalise if acute decompensation; consider TIPS as bridge to transplant; nutrition support; infection surveillance.

Very High Priority

→ MELD-Na ≥35: Very high transplant priority; ICU-level care may be needed; palliative care if no transplant option; aggressive management of HRS, HE, SBP.

Interpretation bands for the MELD-Na. 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.