Calculators · Gastroenterology & Hepatology · Score

MELD-Na (UNOS/OPTN 2016)

Also called MELDNa, MELD sodium, MELD score

Original MELD with the serum-sodium adjustment as used for US liver allocation from 2016 to 2023.

mmol/L

Fill 4 more fields to see the result.

Formula and scoring

MELD(i) = 0.957·ln(Cr) + 0.378·ln(bili) + 1.120·ln(INR) + 0.643, rounded to the tenth then ×10. Lab values < 1.0 set to 1.0; Cr > 4.0 or dialysis → 4.0. If MELD(i) > 11: MELD = MELD(i) + 1.32·(137 − Na) − 0.033·MELD(i)·(137 − Na), Na bounded 125–137. Maximum 40.

Exam and ward pearls

  • Hyponatraemia matters most when MELD is low: each 1 mmol/L fall in Na between 125 and 140 raised hazard of death by about 5% (Kim 2008).
  • The effect of sodium was larger when MELD was low, which is why the Na term shrinks as MELD(i) rises.

When not to rely on it

  • Superseded in the US by MELD 3.0 (2023). Not validated for acute liver failure or exception diagnoses (HCC).

Source

  1. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018-26. doi:10.1056/NEJMoa0801209 · PMID 18768945
  2. OPTN Policy 9.1.D (2016) MELD calculation, reproduced verbatim as Appendix B of the Exalenz SAP for protocol CON-EX-0217 (NCT03462576), ClinicalTrials.gov document, 2019. Link
  3. 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

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

More Gastroenterology & Hepatology calculators