The Model for End-Stage Liver Disease (MELD) score, or MELD Score or MSc, is a scoring system for assessing the severity of the chronic liver disease. It was initially developed to predict the vital prognosis three months after surgery in patients who underwent an intrahepatic shunt via the transjugular route.
It uses serum total bilirubin, serum creatinine, and INR values to predict survival. This score is also used by the United Network for Organ Sharing (UNOS) and Eurotransplant to prioritize the distribution of liver transplants. It is calculated according to the following formula:
MELD = 3.78 x IN( bilirubin [mg/dl] ) + 11.2 x IN( INR ) + 9.57 x IN( creatinine [mg/dL] ) + 6.43.
The following remarks to be made for this calculation are:
the maximum score for the MELD score is 40. All values above 40 receive a score of 40;
if the patient has been on dialysis twice in the past 7 days, the serum creatinine value used should be 4.0 mg dL-1;
any value less than 1 is given the value 1 (i.e. if bilirubin is 0.8, a value of 1.0 is used).