MELDNa Score for End-Stage Liver Disease (NOT appropriate for patients under the age of 12)

 

Input
 

Creatinine		mcmol/L mg% mg/dL mmol/L
Bilirubin		mcmol/L mg% mg/dL
INR		% fraction ratio
Serum Na		mEq/L
Hemodialysis twice in week prior	Yes
	No

 

Results
 

MELD score
MELDNa score

 

 

Notes

• The Model of End-stage Liver Disease, or MELD score is used to estimate relative disease severity and likely survival of patients awaiting liver transplantation.
• The MELDNa score system adds a Serum Na parameter, so the added risk of significant hyponatremia may be taken into account.
• Children under the age of 12 should be assessed by the PELD score.
• If a patient has had 2 or more hemodialysis treatments or 24 hours of CVVHD in the week prior to the time of the scoring, Creatinine will be set to 4 mg/dL, the maximum creatinine level allowed in the model.
• For patients with hepatocellular carcinoma, the PELD/MELD score is increased according to an algorithm established by UNOS (United Network for Organ Sharing.)
• Additional information about the MELD and PELD scores is at the UNOS website, http://optn.transplant.hrsa.gov/resources/professionalResources.asp?index=8

 
Equations used
 

MELDscore = 10 * ((0.957 * ln(Creatinine)) + (0.378 * ln(Bilirubin)) + (1.12 * ln(INR))) + 6.43

MELDNascore = MELDscore - SerumNa - (0.025 * MELDscore * (140 - SerumNa)) + 140

 

 

References

1. Kim WR, Biggins SW, Kremers WK, Wiesner RH, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008 Sep 4;359(10):1018-26. PubMed ID: 18768945