MELD Score Calculator
Model for End-Stage Liver Disease score from bilirubin, INR, and creatinine.
What it does
The Model for End-Stage Liver Disease score, or MELD, is a single number that estimates how urgently a patient with advanced liver disease needs a transplant. It combines three lab values: total bilirubin, the international normalized ratio, and serum creatinine. Higher scores mean a higher short term risk of death.
The tool above takes those three values and returns the MELD score plus the three month mortality band it maps to. It follows the classic three variable formula used by transplant registries, with the same floors and cap that the listing rules apply.
Each value passes through a natural logarithm, so the score rises faster when a lab value climbs from already high levels than when it climbs from near normal. That shape means a small change near the top of a value's range moves the score more than the same change near the bottom.
The listing rules set a floor of 1 on all three inputs, because the maths breaks near zero and because a value below 1 is treated the same as 1. Creatinine is capped at 4, and a patient who has had dialysis at least twice in the past week is assigned a creatinine of 4 regardless of the measured value.
MELD is a planning and priority tool, not a diagnosis. It belongs to a transplant team that also weighs sodium, encephalopathy, infection, and the patient's overall condition. Sodium is added in the MELD-Na version used for some listings, which this page does not model.
How to use
- Enter the total bilirubin in mg/dL.
- Enter the INR, using 1 when there is no anticoagulation effect.
- Enter the serum creatinine in mg/dL.
- Set dialysis to yes if it happened at least twice in the past week.
- Read the MELD score and its mortality band.
- Share the result with the treating clinician rather than acting on it alone.
Formula
- bilirubin
- Total bilirubin in mg/dL, floored at 1.
- INR
- International normalized ratio, floored at 1.
- creatinine
- Serum creatinine in mg/dL, floored at 1 and capped at 4.
- 6.43
- Constant that shifts the score to its usual range.
The raw result is rounded to a whole number and clamped between 6 and 40. Values below 1 for bilirubin, INR, or creatinine are raised to 1. A dialysis patient uses a creatinine of 4 even if the measured value is lower.
Worked example
Example: bilirubin 2.0, INR 1.5, creatinine 1.9
Total bilirubin 2.0 mg/dL, INR 1.5, serum creatinine 1.9 mg/dL, no recent dialysis.
- ln(2.0) = 0.6931, times 3.78 = 2.620.
- ln(1.5) = 0.4055, times 11.2 = 4.541.
- ln(1.9) = 0.6419, times 9.57 = 6.143.
- Sum with the constant: 2.620 + 4.541 + 6.143 + 6.43 = 19.73.
- Rounded to a whole number, the MELD score is 20.
- A score of 20 falls in the band with about 19.6 percent three month mortality.
Reference table
| MELD score | About 3-month mortality |
|---|---|
| 6 to 9 | 1.9 percent |
| 10 to 19 | 6.0 percent |
| 20 to 29 | 19.6 percent |
| 30 to 39 | 52.6 percent |
| 40 and above | 71.3 percent |
Limits
- Covers the classic three variable MELD, not the sodium adjusted MELD-Na.
- Does not include encephalopathy, ascites, or infection.
- Mortality bands come from listed patient cohorts and are not personal predictions.
- Lab units must be mg/dL for bilirubin and creatinine, as the formula expects.
Common mistakes
- Entering bilirubin or creatinine in micromoles per litre without converting.
- Leaving a value below 1 and letting the logarithm break instead of raising it to 1.
- Using the measured creatinine on a dialysis patient instead of the assigned 4.
- Reading the score as a diagnosis rather than a listing priority.
- Confusing classic MELD with the newer MELD-Na that adds sodium.
Try it yourself
Quick checks. Answers sit tucked under each question.
Bilirubin 0.8, INR 1.0, creatinine 0.9, no dialysis?
Every value is floored at 1, giving a MELD of 6.
Bilirubin 3.0, INR 2.0, creatinine 2.0, on dialysis?
Creatinine is set to 4, giving a MELD of 32.
Why does the lowest MELD equal 6?
The formula result is clamped to a floor of 6, the minimum score used for listing.
Questions
What is a normal MELD score?
The scale starts at 6. Scores near 6 reflect mild impairment, and higher scores reflect greater risk.
What does MELD predict?
It estimates three month mortality in advanced liver disease and sets transplant priority.
Why floor the inputs at 1?
The logarithm of a number below 1 is negative and would distort the score, and low values are treated as 1.
What is the creatinine cap?
Creatinine is capped at 4 mg/dL. Dialysis at least twice in a week assigns a value of 4.
How is MELD-Na different?
MELD-Na adds serum sodium to the calculation and is used by some listing systems for allocation.
Can I use this for a child?
No. Children are listed with PELD, which uses different variables.