MELD Score (Liver Disease)
Calculate Model for End-Stage Liver Disease score for liver transplant listing.
🧮 MELD Score Formula
Variables
BilirubinTotal serum bilirubin (mg/dL)INRInternational Normalized RatioCreatinineSerum creatinine (mg/dL)🩺 Kamath et al., Hepatology 2001. MELD ≥15 is the threshold for liver transplant listing in most centers.
📌Kamath et al. Hepatology 2001
📊 Quick Reference
| Input / Parameter | Description | Example Value |
|---|---|---|
| Bilirubin | Total serum bilirubin (mg/dL) | 3.8 mg/dL |
| Albumin | Serum albumin (g/dL) | 2.4 g/dL |
| INR | International Normalized Ratio | 1.8 |
| Creatinine | Serum creatinine (mg/dL) for MELD | 1.3 mg/dL |
| Ascites grade | None / Mild / Moderate / Severe for Child-Pugh | Moderate (score 2) |
| MELD output | Score 6–40: higher = worse prognosis | MELD 22 → ~10% 90-day mortality |
| Child-Pugh class | A (5–6) / B (7–9) / C (10–15) | Class B (score 8) |
ℹ️ About This Calculator
The MELD Score (Liver Disease) is a validated hepatic or gastrointestinal scoring system used to assess disease severity, estimate prognosis, guide transplant listing decisions, or evaluate procedural risk in patients with liver disease or gastrointestinal conditions. It is endorsed by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), and the British Society of Gastroenterology (BSG).
Chronic liver disease affects approximately 1.5 billion people globally (EASL), with cirrhosis and its complications — including portal hypertension, variceal haemorrhage, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome — representing major causes of morbidity and mortality. Validated scoring systems like MELD, Child-Pugh, and SAAG provide objective, reproducible severity assessment that guides decisions about transplant listing, intensive monitoring, prophylactic interventions, and end-of-life planning.
The exact formula — including every variable, coefficient, and clinical grading scale — is shown in the Formula section below. For hepatic scoring systems, formula transparency is especially important because small differences in laboratory values can shift a patient between clinically significant thresholds. For example, in MELD scoring, a creatinine that rises from 1.2 to 2.0 mg/dL raises the MELD score by approximately 3 points — which can change the transplant listing priority and 90-day mortality estimate.
Critical requirements for valid scoring: hepatic scores are only accurate when calculated from simultaneous laboratory values obtained on the same day from a stable clinical state. MELD or Child-Pugh scores calculated from values obtained during acute hepatic decompensation (bleeding, infection, AKI) do not represent the patient's stable baseline. For Child-Pugh scoring, the subjective components — ascites severity and encephalopathy grade — should be assessed by an experienced clinician using standardised grading criteria, as inter-observer variability here is a significant source of scoring inconsistency.
All calculations run in your browser. No laboratory values, clinical parameters, or patient information is transmitted to any server or stored. This ensures compliance with healthcare data privacy requirements when using the tool in clinical consultations or ward rounds.
For MELD scores ≥15, Child-Pugh Class C, or any patient with decompensated cirrhosis, prompt referral to a hepatologist or liver transplant centre is indicated. Liver transplant evaluation is a complex, time-sensitive multidisciplinary process — early referral improves outcomes. For all patients with liver disease, gastroenterologist or hepatologist involvement should guide varices surveillance, SBP prophylaxis, hepatocellular carcinoma screening, and management of hepatic decompensation.
📌Clinical Reference: Kamath et al. Hepatology 2001
📋 How to Use This Calculator
- 1
Obtain current laboratory values
Enter the most recent serum bilirubin, albumin, INR/PT, and creatinine from a stable clinical state. Hepatic scores (MELD, Child-Pugh) are most accurate when values reflect the patient's baseline — not during acute decompensation.
- 2
Assess clinical parameters
For Child-Pugh scoring, grade ascites severity (absent/mild/moderate) and hepatic encephalopathy grade (none/1–2/3–4) based on clinical examination findings.
- 3
Calculate the hepatic score
Enter all required variables and click Calculate. The tool returns the MELD, Child-Pugh class, or GI severity score with the validated prognostic interpretation.
- 4
Interpret against clinical thresholds
Review the score against published outcome data. MELD ≥15 indicates transplant listing; Child-Pugh class C signals decompensated cirrhosis with significant 1-year mortality.
- 5
Discuss with gastroenterology or hepatology
For MELD scores suggesting transplant candidacy or Child-Pugh class C, refer promptly to a hepatologist. Transplant evaluation and listing requires multidisciplinary team assessment.
🎯 When to Use This Calculator
Liver transplant listing and allocation
Calculate MELD score to assess candidacy for liver transplant listing and determine organ allocation priority. MELD ≥15 is the general threshold for listing in most centres.
Cirrhosis severity assessment
Use Child-Pugh score to classify cirrhosis severity (A/B/C) at each outpatient visit, guide prophylaxis decisions (varices, SBP), and estimate 1-year survival.
Ascites aetiology differentiation
Calculate SAAG from simultaneous serum and ascitic fluid albumin to distinguish portal hypertension-related ascites (SAAG ≥1.1) from non-portal causes (SAAG <1.1).
Acute pancreatitis severity prediction
Apply Ranson's Criteria at admission and 48 hours to predict severe acute pancreatitis requiring ICU monitoring, aggressive fluid resuscitation, and early enteral nutrition.
Pre-procedure liver function assessment
Calculate Child-Pugh or MELD score before endoscopy, surgery, or procedures in cirrhotic patients to quantify procedural risk and guide anaesthetic planning.
💡 Clinical Pro Tips
MELD score should always be calculated from simultaneous lab values obtained on the same day. Using creatinine from one date and bilirubin from another creates artificially high or low MELD scores. Repeat labs on the same day before any transplant-related decision.
Child-Pugh ascites grading is the most subjective component of the score and the most common source of inter-rater variability. Use ultrasound assessment to grade ascites objectively when clinical examination is equivocal. 'Mild' (grade 1, score 2) = detectable only on ultrasound; 'Moderate' (grade 2, score 2) = clinically apparent; 'Severe' (grade 3, score 3) = gross/tense ascites.
Ranson's criteria require two assessment time points (admission and 48 hours) — you cannot calculate the full score at admission alone. The 48-hour criteria (falling haematocrit, rising BUN, hypocalcaemia, base deficit, fluid sequestration) are the most predictive components for severe pancreatitis.
SAAG must be calculated from albumin measured in serum and ascitic fluid obtained on the SAME DAY during paracentesis. Serum albumin measured days before the tap may not reflect the current serum level, especially in patients with rapidly fluctuating liver function.
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