MELD Score

What is a MELD score?

Your MELD score is a number between 6 and 40 that’s calculated to determine how soon you need a liver transplant. The higher your MELD score, the sicker you are with liver disease. This score is just one factor that helps your healthcare provider decide where to place you on the liver transplant waiting list.

MELD stands for Model for End-Stage Liver Disease. It’s a mathematical formula that takes different health metrics into account, like blood test results, your age and health history. This formula is for people older than 12. For younger children, providers use the Pediatric End-Stage Liver Disease (PELD) model.

How is a MELD score calculated?

Your provider calculates your MELD score based on the results of several blood tests:

• INR (international normalized ratio): This measures how well your blood clots. A longer clotting time usually means your liver isn’t functioning as well.
• Total bilirubin: This measures how well your liver metabolizes and releases (excretes) bile. Higher bilirubin levels mean poorer liver function.
• Creatinine: This measures kidney function. The reason why kidney function matters in liver disease is that when liver disease advances, your kidneys stop functioning.
• Serum sodium: This shows how much sodium is in your blood, which can tell how well your liver is working. Low levels mean poor liver function.
• Albumin levels: This is a protein your liver makes that helps retain water in your blood. Low levels can point to poor liver function.

The MELD score calculation is complex and includes more than just your blood test results.

Some of the other factors healthcare providers consider are:

• Your medical history, including the type of liver disease you have and how severe it is
• Your age and sex recorded at birth
• Other health conditions you have, and if they could cause complications
• Social and lifestyle factors that may affect the success of the transplant

Sometimes, your MELD score doesn’t accurately reflect how urgently you need a liver transplant. In this case, your provider can request extra points be added to your score to account for other conditions.

Conditions that may qualify you for extra points include:

• Acute liver failure
• Liver cancer
• Hepatopulmonary syndrome (low oxygen in your blood due to liver disease)
• Portopulmonary hypertension (high blood pressure in your lungs caused by liver disease)
• Polycystic liver disease (rare genetic disease)
• Cholangitis (chronic inflammation in your bile ducts)

Ask your healthcare provider about the factors that went into calculating your MELD score.

Can your MELD score change?

Yes. Your healthcare provider will order new blood tests on a regular basis to update your MELD score. How often this happens will depend on how fast your condition changes. Your healthcare provider is in charge of monitoring your condition. Your score may change if your condition worsens or improves.

How do I interpret my MELD score?

Healthcare providers use the MELD score to estimate:

1. Your risk of death in the next 90 days from liver disease
2. How urgently you need a liver transplant

Mortality risk

Here’s what your MELD score suggests about your prognosis (outlook):

It’s impossible to know for sure what your life expectancy is. But your MELD score gives your providers a general idea. Then, they use the score to help determine how urgently you need a liver transplant.

Your MELD score isn’t the only thing that determines how long it may take for you to get a liver transplant. Factors like your blood type and the availability of donors in your region play a role, too.