This MELD calculator determines the MELD score from INR, bilirubin and creatinin levels and assigns chances of survival with end of stage liver disease. You can read more about the formula used below the form.
How does this MELD calculator work?
This is a health tool that determines the MELD Score which is used to estimate the relative severity of the chronic liver disease.
This MELD calculator uses the international normalized ratio time (INR), the serum creatinine and serum bilirubine values in order to display the MELD Score. This helps provide an insight on the level of the disease and its stage in the United Network for Organ Sharing (UNOS) prioritizing allocation.
The MELD uses the international normalized ratio for prothrombin time (INR), the serum creatinine and serum bilirubine values in order to display the MELD Score according to the following formula:
Original MELD Score = 10 * [(0.957 * ln(Creatinine)) + (0.378 * ln(Bilirubin)) + (1.12 * ln(INR))] + 6.43
In January 2016, OPTN changed Policy 9.1 in regard to MELD score with the introduction of serum sodium as factor in the calculation of the score.
Serum sodium values are input in mEq/L and then normal range is considered between 125 and 137 mEq/L. In case the patient is known hyperglicemic with glucose > 120 mg/dL a sodium correction needs to be applied.
The 2016 MELD score formula is the following:
MELD Score (2016) = MELD(i) + 1.32*(137-Na) – [0.033*MELD(i)*(137-Na)]
Where MELD(i) is the original MELD score without serum sodium.
With Serum Sodium between 125 and 137 mEq/L.
Adjustments to the method:
This log scales calculations therefore any value that is less than 1 is automatically adjusted to the lower limit value of 1 to prevent generating a negative score.
Since the upper limit for the serum Creatinine value is 4 mg/dL it means that for those patients that have had two round of dialysis in the past week, the value will be automatically adjusted to 4.0.
Let’s take for instance the case of a person with an INR value of 1.1, bilirubin of 1.5 mg/dL, creatinine 2.7 mg/dL, no hemodialysis and a serum sodium of 135 mEq/L. The results displayed are:
■ Original MELD Score (without Serum Sodium) = 18.544;
■ 2016 Modified MELD Score (with Sorium Sodium) = 19.96.
What is MELD?
The Model of End Stage Liver Disease is a score used to estimate the relative severity of the chronic liver disease and the chances of survival during the expectation period for the liver transplant.
This score is now used by the United Network for Organ Sharing (UNOS) for prioritizing allocation of liver transplants.
The estimated 3-month mortality based on the original MELD score:
■ 10-19 - 6.0% mortality;
■ 20-29 - 19.6% mortality;
■ 30-39 - 52.6% mortality;
■ 40 or more - 71.3% mortality.
1) Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D'Amico G, Dickson ER, Kim WR (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33 (2): 464–70.
2) Kamath PS, Kim WR (2007) The model for end-stage liver disease (MELD) Hepatology 45 (3): 797–805.
3) Kremers WK, van IJperen M, Kim WR, Freeman RB, Harper AM, Kamath PS, Wiesner RH. (2004) MELD score as a predictor of pretransplant and posttransplant survival in OPTN/UNOS status 1 patients. Hepatology; 39(3):764-9.
4) Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, Kremers W, Lake J, Howard T, Merion RM, Wolfe RA, Krom R; United Network for Organ Sharing Liver Disease Severity Score Committee. (2003) Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology; 124(1):91-6.06 Dec, 2014