Calculators · Gastroenterology & Hepatology · Score

MELD 3.0

Also called MELD 3, Model for End-Stage Liver Disease 3.0

90-day waiting-list mortality score for adults with end-stage liver disease; adds female sex and albumin to MELD-Na.

Sex
mmol/L

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Formula and scoring

MELD 3.0 = 1.33 (if female) + 4.56·ln(bili) + 0.82·(137 − Na) − 0.24·(137 − Na)·ln(bili) + 9.09·ln(INR) + 11.14·ln(Cr) + 1.85·(3.5 − Alb) − 1.83·(3.5 − Alb)·ln(Cr) + 6, rounded. Bili, INR, Cr < 1.0 set to 1.0; Cr capped at 3.0 mg/dL (also 3.0 if on dialysis); Na bounded 125–137; albumin bounded 1.5–3.5 g/dL.

Exam and ward pearls

  • Creatinine ceiling dropped from 4.0 (MELD-Na) to 3.0 mg/dL, and women get 1.33 extra points because creatinine overstates their GFR.
  • Albumin–creatinine interaction: once creatinine is about 2.7 mg/dL or higher, low albumin no longer raises the score.
  • OPTN adopted MELD 3.0 for US liver allocation through its June 2022 policy change (cited by Kwong 2023).

When not to rely on it

  • Derived in US transplant candidates aged ≥18; adolescents (12–17) use a different constant (Kwong 2023).
  • Albumin infusion raises the albumin term; do not withhold clinically indicated albumin to game the score.

Source

  1. Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0: the Model for End-Stage Liver Disease updated for the modern era. Gastroenterology. 2021;161(6):1887-1895.e4. doi:10.1053/j.gastro.2021.08.050 · PMID 34481845
  2. Kwong AJ, Zhang KY, Ebel N, Mannalithara A, Kim WR. MELD 3.0 for adolescent liver transplant candidates. Hepatology. 2023;78(2):540-546. doi:10.1097/HEP.0000000000000352 · PMID 36943091

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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