The MELD score ranges from 6 to 40 and predicts 3-month mortality in patients with chronic liver disease. A score below 10 suggests relatively stable disease with low short-term mortality (less than 2%). Scores of 10–19 indicate moderate disease with increasing mortality risk (6–20%). Scores of 20–29 represent serious liver disease with substantial mortality risk. Scores of 30 or above indicate very severe disease with a 3-month mortality exceeding 50%.

If you provided serum sodium, the MELD-Na score is also calculated. MELD-Na generally provides a more accurate mortality prediction than standard MELD, particularly in patients with ascites and hyponatremia — conditions where sodium levels reflect disease severity not captured by bilirubin, INR, and creatinine alone.

The MELD score is primarily used to determine priority for liver transplant allocation. In the United States, UNOS uses the MELD-Na score to rank patients on the transplant waiting list — higher scores receive higher priority. It is also used to assess prognosis in patients with cirrhosis, guide the timing of transplant referral, and predict outcomes after transjugular intrahepatic portosystemic shunt (TIPS) procedures.

Clinicians also use the MELD score to help guide decisions about the urgency of interventions, monitoring frequency, and discussions about goals of care in advanced liver disease.

The MELD score uses only three laboratory values and does not capture several clinically important aspects of liver disease. Conditions like hepatocellular carcinoma, hepatopulmonary syndrome, recurrent cholangitis, and intractable ascites may carry high mortality but produce a low MELD score. UNOS addresses this through exception points for specific conditions.

Creatinine — one of the three MELD inputs — is influenced by factors beyond liver and kidney function. Patients with low muscle mass (common in advanced cirrhosis) may have misleadingly low creatinine values, leading to MELD scores that underestimate disease severity. Additionally, creatinine is capped at 4.0 mg/dL in the formula, and patients on dialysis are automatically assigned a creatinine of 4.0.

Lab values can fluctuate with acute illness, dehydration, or infection. A single MELD score is a snapshot — serial measurements and trend analysis provide a more complete clinical picture.