MELD Score
What your number means and how it sets your place on the list
Key takeaway: Your MELD score is a number from 6 to 40 built from five routine blood tests. The higher it is, the sicker your liver is and the higher you rank for a donor liver. But the same score can mean a wait of weeks at one center and years at another. Calculate your MELD 3.0 score.
What the MELD score measures
MELD stands for Model for End-Stage Liver Disease. It estimates how likely a person with advanced liver disease is to die within the next three months without a transplant. When the national transplant system adopted MELD in 2002, it replaced a system that relied heavily on time spent waiting. Since then, the sickest patients have been offered livers first.
The study that tested MELD for allocation found that patients with a score under 9 had a 1.9% chance of dying within three months, while patients with a score of 40 or higher had a 71.3% chance. Every point matters, which is why the score is updated as your labs change.
MELD applies to patients 12 and older. Children under 12 are ranked by a related score called PELD.
MELD 3.0: the version used today
In July 2023, U.S. liver allocation switched from MELD-Na to MELD 3.0. It uses five lab values and one more factor:
| Input | What it tells your team |
|---|---|
| Bilirubin | How well your liver clears bile from the blood |
| INR | How well your liver makes the proteins that help blood clot |
| Creatinine | How well your kidneys work, which often worsens as the liver fails |
| Sodium | Low sodium is linked to fluid buildup and higher risk |
| Albumin | A protein made by the liver; low levels signal advanced disease |
| Sex | Women get a small adjustment because older versions underestimated their risk |
The researchers who built MELD 3.0 found it predicts 90-day survival better than MELD-Na. Adding albumin and sex, and lowering the creatinine cap from 4.0 to 3.0, reduced a disadvantage women had faced on the list. Try it yourself with our MELD calculator.
MELD score ranges, in plain language
| Score | What it usually means |
|---|---|
| 6–14 | Liver disease is present but the short-term risk is lower. A low score does not mean low risk overall: see what MELD does not count. |
| 15–24 | The range where practice guidance recommends a transplant evaluation if one has not happened. Ask about a referral and read who qualifies for a liver transplant. |
| 25–29 | High priority. In many regions, patients are transplanted in this range; in others they wait longer. |
| 30–40 | The sickest patients on the list, offered livers from a wider area first. |
What your MELD score means for your wait
- Higher MELD, higher priority. When a donor liver becomes available, compatible candidates are ranked mainly by MELD, then by distance from the donor hospital and blood type.
- Your score moves. Your center reports new labs on a schedule set by OPTN policy. The higher your score, the more often it must be updated, as often as weekly for the sickest patients.
- Same score, different waits. Centers with more donor livers nearby transplant at lower scores. The number to ask about is your center's median MELD at transplant.
- Exception points. Some conditions, such as certain liver cancers, receive an assigned score because the lab formula understates their risk.
- You can list at more than one center. Dual listing can put you where patients are transplanted at your score sooner.
See wait times for every program on the liver transplant waiting list guide, or compare liver transplant centers by state.
Frequently asked questions
What is a MELD score?
MELD (Model for End-Stage Liver Disease) is a number from 6 to 40 that estimates how likely a person with advanced liver disease is to die within 90 days without a transplant. In the U.S., it sets the order in which adults on the liver transplant waiting list are offered donor livers.
What is a good MELD score?
A lower score means less severe liver disease right now. For transplant, there is no "good" score: a higher score brings higher priority but also means you are sicker. Ask your hepatologist what your trend means.
Does a higher MELD score get me a liver sooner?
Generally, yes. Donor livers are offered first to the sickest compatible candidates nearby, ranked by MELD for adults and PELD for children. But the score at which patients actually receive a liver differs a lot by center, and blood type, body size and exception points matter too. See median MELD at transplant.
My MELD is 27. Which centers transplant patients at that score?
Centers with more donor livers nearby transplant at lower scores. Compare liver transplant centers by typical wait, and read median MELD at transplant, then ask each center what MELD its patients usually reach at transplant.
What is the difference between MELD, MELD-Na and MELD 3.0?
The original MELD (2002) used bilirubin, INR and creatinine. MELD-Na (2016) added sodium. MELD 3.0 (July 2023) added albumin and sex and lowered the creatinine cap, which made the score more accurate, especially for women.
How often is the MELD score updated?
Your center sends new lab values on a schedule set by OPTN policy. The higher your score, the more often it must be updated, as often as weekly for the sickest patients.
Can I calculate my own MELD score?
Yes. Use our MELD 3.0 calculator. Your official score is the one your center reports.
Sources
- Kim WR et al. MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era. Gastroenterology 2021
- Wiesner R et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003
- OPTN Policies: Policy 9, Allocation of Livers and Liver-Intestines
- HRSA/OPTN: Liver and intestine resources, MELD 3.0 and PELD implementation
- Martin P et al. Evaluation for liver transplantation in adults: 2013 practice guideline by AASLD and AST. Hepatology 2014
About this content
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.