# MELD Score (End-Stage Liver Disease)

Calculate the current UNOS/OPTN base MELD(i) score for end-stage liver disease and transplant allocation: MELD(i) = (0.957·ln(creatinine) + 0.378·ln(bilirubin) + 1.120·ln(INR) + 0.643) × 10, rounded and clamped to 6–40. Creatinine is floored at 1.0, capped at 4.0 mg/dL, and forced to 4.0 if dialyzed ≥2× or on CVVHD ≥24 h in the past week; bilirubin and INR are floored at 1.0. NOTE: in the US, MELD-Na (2016) and then MELD 3.0 (Jul 2023, adds sex and albumin) have superseded this base MELD for adult allocation — this tool implements the classic base MELD(i) for education / non-US use. Derived from Kamath 2001 (Hepatology) and UNOS/OPTN policy. Not medical advice.

> Canonical page: https://elysiatools.com/en/tools/meld-score

- **Category:** Health

- **Keywords:** MELD, end-stage liver disease, ESLD, cirrhosis, liver transplant, UNOS, OPTN, bilirubin, creatinine, INR, hepatology

## Overview

Calculate the classic UNOS/OPTN base MELD(i) score from serum creatinine, total bilirubin, INR, and recent dialysis status. The result is rounded and limited to 6–40 for educational or non-US use; it is not medical advice.

## Inputs

- **Serum Creatinine (mg/dL)** (number): Serum creatinine in mg/dL. Floored at 1.0, capped at 4.0 (4.0 if dialyzed). Must be positive.
- **Total Bilirubin (mg/dL)** (number): Total bilirubin in mg/dL. Floored at 1.0. Must be positive.
- **INR** (number): International Normalized Ratio (INR). Floored at 1.0. Must be positive.
- **Dialysis ≥ 2× or CVVHD ≥ 24 h in past week** (checkbox): If dialyzed at least twice or on CVVHD for ≥ 24 hours in the past week, creatinine is set to 4.0 mg/dL.
- **Decimal Places** (number)

## When to use

- Estimate a classic base MELD(i) score for end-stage liver disease using laboratory values.
- Review how creatinine, bilirubin, INR, and recent dialysis affect the calculation.
- Use the formula for education or contexts where the classic MELD(i), rather than MELD-Na or MELD 3.0, is required.

## How it works

- Enter positive values for serum creatinine in mg/dL, total bilirubin in mg/dL, and INR.
- Select the dialysis option if the patient received dialysis at least twice or CVVHD for at least 24 hours during the past week.
- The calculator applies the specified floors and caps: creatinine is limited to 1.0–4.0, while bilirubin and INR are floored at 1.0.
- It applies the base MELD(i) formula, rounds the result, and clamps the score to a range of 6–40.

## Use cases

- Medical education on the classic MELD(i) formula and its laboratory inputs.
- Hepatology review of how dialysis status and value floors or caps change the score.
- Non-US or historical analysis requiring the UNOS/OPTN base MELD(i) calculation.

## Frequently asked questions

### What inputs are required?

Enter serum creatinine, total bilirubin, and INR. The dialysis checkbox is optional.

### How is creatinine adjusted?

Creatinine is floored at 1.0 mg/dL and capped at 4.0 mg/dL. Dialysis criteria in the past week force it to 4.0.

### What happens to low bilirubin or INR values?

Bilirubin and INR values below 1.0 are calculated as 1.0.

### What score range does the calculator return?

The rounded MELD(i) score is limited to 6–40.

### Is this the current US adult transplant allocation score?

No. US adult allocation uses MELD-Na and MELD 3.0; this tool calculates the classic base MELD(i) for education or non-US use.

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