Model for End-Stage Liver Disease (Pre-2016)
Total Score
Estimated 3-month mortality: ~1.9%.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.
The MELD (Model for End-Stage Liver Disease) score is an objective, lab-based scoring system used to predict 3-month mortality in patients with advanced chronic liver disease. Relying purely on objective lab values (Bilirubin, Creatinine, INR, and recently Sodium), it serves as the primary tool for prioritizing patients on the liver transplant waiting list.
The inclusion of Serum Sodium (MELD-Na) significantly improved the score's accuracy, as dilutional hyponatremia is a hallmark of severe portal hypertension and splanchnic vasodilation. A patient with a seemingly stable MELD but refractory hyponatremia is at extreme risk.
Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464-470.
Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130(6):1652-1660.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Use to predict 90-day mortality in patients with end-stage liver disease and to prioritize candidates on the liver transplant waitlist. UNOS/OPTN uses MELD-Na (MELD with serum sodium) for organ allocation in the United States. MELD <10 generally indicates a low risk of short-term mortality without transplant.
MELD score interpretation by mortality risk: <10 (~2% 90-day mortality), 10–19 (~6%), 20–29 (~20%), 30–39 (~53%), ≥40 (~71%). A MELD score ≥15 is the threshold above which transplantation provides a survival benefit over remaining on the waitlist.
Creatinine values in patients on dialysis should be automatically set to 4.0 mg/dL (the formula maximum) per UNOS policy. Using a low creatinine from a dialysis patient without this correction will severely underestimate their disease severity and transplant urgency.