Median MELD at transplant (MMaT) is the middle MELD score of the patients who actually received a liver: half were transplanted at or below it. Here is what the number means, why it differs from center to center, how national policy uses it for exception points, and how to ask your team about it.
MELD stands for Model for End-Stage Liver Disease. It is a score from 6 to 40, calculated from routine blood tests, that estimates how likely an adult with liver disease is to die within the next three months without a transplant. On the liver transplant waiting list, a higher MELD score generally means a higher place in line for a deceased-donor liver.
Since July 2023, the U.S. system has used MELD 3.0, which adds serum sodium, albumin and sex to bilirubin, INR and creatinine. It was designed to predict risk more accurately, especially for women. Read our full guide to the MELD score, or try the MELD 3.0 calculator to see how lab values become a score.
Median MELD at transplant (MMaT) describes the MELD scores of patients at the moment they actually received a liver. "Median" means the middle value. If a center's median MELD at transplant is 26, then half of the patients transplanted at that center had a MELD at or below 26, and half had a MELD above it.
It is not a cutoff. Nobody is turned away below the median, and patients are transplanted at scores well under it and well over it. It is simply a summary of where, in practice, transplants have been happening.
You will see the term used in two different ways, and it helps to keep them apart:
The median MELD at transplant differs from place to place. Published research has grouped parts of the country into areas where the median was under 28, between 28 and 30, and above 30. Three main things drive the difference:
Living-donor transplants are another factor. A patient with a living donor does not need to wait for a high enough MELD to receive a deceased-donor offer.
The median MELD at transplant gives you a rough sense of how your own score compares with the scores at which patients near you are actually being transplanted. If your MELD is 18 and you are listed where the median MELD at transplant is in the low 30s, you may wait much longer, and your health may change while you wait. If you are listed where the median is in the low 20s, the gap is smaller.
It is only a rough guide. Your blood type, body size, other medical conditions, exception points, willingness to accept certain kinds of donor livers, and plain chance all affect your own wait. A median also looks backward: it summarizes transplants that have already happened.
This is one reason some patients look into dual listing, which means being evaluated and listed at a second transplant center, often in a different area. OPTN rules allow it, but every center does its own evaluation, insurance coverage varies, and you must be able to get to the second center quickly when an offer comes. Whether it helps depends on your situation. It is a conversation to have with your transplant team, not a decision to make from a single number.
Some patients face serious risks that their lab-based MELD does not capture. The most common example is liver cancer (hepatocellular carcinoma, or HCC). These patients can be given a MELD exception score. Since 2019, national policy has set most of these exception scores relative to the median MELD at transplant rather than as fixed numbers.
Because the calculation is centered on the donor hospital, a patient's exception score can differ from one organ offer to the next. Research suggests the move to donor-hospital calculation reduced the transplant advantage HCC candidates previously had over patients without cancer. If you have or may get exception points, ask your team how your current score is being set.
There is no single public table that lists a clean median MELD at transplant for every U.S. center. We checked the SRTR program-specific report tables we publish elsewhere on this site, and none of them contains a center-level median MELD at transplant for deceased-donor recipients. Rather than estimate a figure, we show only the numbers that centers have reported to us directly, with their source:
| Transplant center | State | Median MELD at transplant (center-reported) | Source |
|---|---|---|---|
| Cleveland Clinic | Ohio | 26 | Cleveland Clinic Foundation, site review 2026-09-09 |
| Intermountain Medical Center | Utah | 24 | Intermountain Health, UNOS-submitted figures (pending SRTR publication) |
A center-reported figure may cover a different time period, or count different patients, than the official OPTN calculation used for exception points, so compare these numbers with care. For every other program, see the liver transplant centers directory for the SRTR waiting-list and outcome data we do publish, or explore median MELD at transplant by region.
The most reliable source is your own transplant team. Centers track this number closely, and you are entitled to ask. You can also look up your program on the SRTR transplant center search. Each program's report describes its waiting list and its recent transplant recipients, including how sick recipients were at transplant. Where MELD at transplant appears there, it is grouped into score ranges rather than given as one median.
Questions you might bring to your next appointment:
There is no single score that guarantees a transplant. Many patients are referred for a transplant evaluation once their MELD reaches about 15, and patients are transplanted at a wide range of scores. The median MELD at transplant (MMaT) near your center, meaning the middle score of patients recently transplanted there, gives a rough sense of where transplants are happening. Your blood type, size, exception points and the donor livers your center accepts all matter too. Ask your transplant team what is typical for patients like you.
MMaT stands for median MELD at transplant. It is the middle MELD score among patients who received a liver: half were transplanted at or below that score and half above it. OPTN also calculates an official median MELD at transplant, which it uses to set exception scores.
MMaT minus 3 is the exception score given to most patients with a standardized MELD exception, such as liver cancer (HCC) that meets national criteria. The score is the median MELD at transplant for recent transplants within 250 nautical miles of the donor hospital, minus 3 points. For HCC, it applies after a six-month waiting period.
Areas with more donor livers relative to the number of people waiting tend to transplant patients at lower scores. Where a center sits under acuity-circle allocation matters too. Centers that accept a wider range of donor livers, or that do more living-donor transplants, can also transplant patients at lower MELD scores.
The official OPTN median MELD at transplant is recalculated every 180 days using the previous year of transplants. Exception scores tied to it can go up or down when that happens. A center's own median also shifts as its donor supply and practices change.
Ask your transplant team first. It is the most reliable source and should tell you what time period the figure covers. The SRTR program-specific report for your center describes its recent transplant recipients, including how sick they were at transplant, usually grouped by MELD range. This page also lists the figures that centers have reported to us directly.
It can for some patients, but not for everyone. Being listed at a second center in a different area may mean you receive offers there at a lower score. You will need a separate evaluation, insurance approval and a way to reach that center quickly. Talk it through with your transplant team.
Medically reviewed by James F. Trotter, MD and Joseph S. Redman, MD, PhD of the National Friends Medical Advisory Board on . Reviewers check clinical statements against the cited sources; data tables come from the public SRTR program-specific reports and OPTN policy.
Published by Friends of the National Liver Waiting List, a 501(c)(3) patient advocacy charity. Updated . Not medical advice: talk with your hepatologist or transplant team about your own care.