Calculate the UNOS/OPTN MELD-Na score — the sodium-modified MELD used for adult liver transplant allocation in the US from January 2016 until superseded by MELD 3.0 in July 2023. First compute the base MELD(i) (same formula as MELD, clamped 6–40). If MELD(i) > 11: MELD-Na = MELD(i) + 1.32·(137 − Na) − 0.033·MELD(i)·(137 − Na), with sodium clamped to 125–137 mmol/L. If MELD(i) ≤ 11, MELD-Na = MELD(i) (no sodium adjustment). The result is rounded and clamped to 6–40. Rationale: hyponatremia (Na < 137) predicts worse waitlist mortality beyond what MELD(i) captures, so the score is inflated; the interaction term scales the sodium penalty down at very high MELD(i). Derived from Kim/Biggins 2008 (NEJM) and UNOS/OPTN policy. Not medical advice.
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Key facts
Category
Health
Input types
number, checkbox
Output type
json
Sample coverage
4
API ready
Yes
Overview
Calculate the UNOS/OPTN MELD-Na score from serum creatinine, total bilirubin, INR, sodium, and recent dialysis status. The result includes the sodium-adjusted score, base MELD(i), and calculation details in JSON. This tool is for reference and is not medical advice.
When to use
Estimate the sodium-modified MELD score using current laboratory values.
Check how sodium below 137 mmol/L changes a base MELD(i) above 11.
Review the capped inputs, dialysis adjustment, and final MELD-Na result in structured JSON.
How it works
1Enter serum creatinine, total bilirubin, INR, and serum sodium.
2Select the dialysis option if dialysis occurred at least twice or CVVHD lasted at least 24 hours in the past week.
3The tool applies the stated input caps, calculates MELD(i), and limits it to 6–40.
4If MELD(i) is above 11, sodium is clamped to 125–137 mmol/L and applied to the MELD-Na formula; the final score is rounded and clamped to 6–40.
Use cases
Clinicians and trainees reviewing how creatinine, bilirubin, INR, sodium, and dialysis status affect MELD-Na.
Researchers reproducing the stated UNOS/OPTN MELD-Na calculation with capped laboratory inputs.
Educational comparisons of a base MELD(i) with cases where hyponatremia adds a sodium adjustment.
Examples
1. Hyponatremia increases the score
Hepatology trainee
Background
A trainee wants to see how sodium below 137 mmol/L changes a patient’s base MELD(i).
Problem
Calculate MELD-Na from creatinine 1.5 mg/dL, bilirubin 3.0 mg/dL, INR 1.8, and sodium 130 mmol/L.
How to use
Enter the four laboratory values, leave dialysis unchecked, and run the calculation.