AST-to-Platelet Ratio Index (APRI Score)Acute Liver Failure Study Group Index (ALFSG Index)Age, Bilirubin, INR and Creatinine Score (ABIC Score)Albumin-Bilirubin Grade (ALBI Score)BMI, AST/ALT Ratio, and Diabetes Score (BARD Score)CLIF-C ACLF Score for Acute-on-Chronic Liver Failure (CLIF-C ACLF)CLIF-C AD Score for Acute Decompensation of Cirrhosis (CLIF-C AD)CLIF-SOFA Score for Organ Failure Assessment (CLIF-SOFA)Cancer of the Liver Italian Program Score (CLIP Score)Child-Pugh Classification for Cirrhosis (Child-Pugh)Chinese University Prognostic Index (CUPI Score)Fibrosis-4 Index (FIB-4 Index)Lille Model for Alcoholic Hepatitis (Lille Model)Maddrey Discriminant Function (Maddrey DF)Model for End-Stage Liver Disease (MELD Score)NAFLD Fibrosis Score (NFS)Simplified Autoimmune Hepatitis Score (Simplified AIH)

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Model for End-Stage Liver Disease (MELD Score)

UNOS Allocation & Mortality Modeling

Clinical Substrate

Bilirubin (mg/dL)

Creatinine (mg/dL)

INR

Sodium (mEq/L)

Clinical Standard

MELD-Na is the universal prioritisation protocol for liver allocation in the United States (UNOS/OPTN).

Hepatology Engine

Enter serum lab values to execute 90-day mortality modeling and allocation indexing.

Guidelines & Evidence

Verified

Last Review: 2026

Clinical Significance

Transplant Allocation Standard

The MELD score was adopted in 2002 to replace the Child-Pugh score, with the goal of creating a "sickest first" allocation system that relies on objective data rather than subjective clinical assessments. This transition significantly reduced the influence of clinician bias in organ allocation.

The Sodium (Na) Factor

In 2016, the formula was updated to include serum sodium. Hyponatremia is a potent independent predictor of death in cirrhotic patients, reflecting the severity of portal hypertension, the degree of effective arterial blood volume depletion, and the activation of the renin-angiotensin-aldosterone system.

Predicting 90-Day Mortality

Beyond transplant, MELD-Na is used to estimate the risk of death in hospitalized cirrhotic patients and to predict the outcome of surgical procedures (e.g., TIPS placement). It has also been validated for predicting outcomes in acute alcoholic hepatitis and acute liver failure.

Global Adoption

Since its introduction, the MELD score has been adopted by Eurotransplant, Brazil, Argentina, and several other national organ sharing organizations, making it the most universally recognized liver prognostic tool in history.

Last Comprehensive Review: 2026