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MELD-Na (UNOS 2016) Calculator

MELD-Na is the United Network for Organ Sharing (UNOS) score used to prioritise patients for liver transplantation and prognosticate end-stage liver disease. UNOS adopted the MELD-Na variant in 2016 to incorporate serum sodium, after data showed hyponatraemia independently predicts mortality in cirrhosis. The score uses creatinine, bilirubin, INR, sodium, and dialysis status, with policy-defined floors and caps (creatinine clamped 1.0–4.0, sodium clamped 125–137). This calculator implements MELD-Na 2016 with the standard adjustments. UNOS adopted MELD 3.0 in 2023 with sex and albumin terms; this calculator focuses on the longstanding MELD-Na.

This tool is for educational and decision-support use only. It does not replace independent clinical judgement. Always verify against the current guideline, FDA label, or specialty reference cited below before acting. Do not enter patient identifiers (name, MRN, dates of service).

UNOS / OPTN MELD-Na Policy (2016) (2016) — UNOS / OPTN — read source Primary publication: Kim WR et al., NEJM 2008 (Hyponatraemia and mortality in cirrhosis)

Who this is for

Hepatology and transplant fellows estimating wait-list priority
Hospitalists managing decompensated cirrhosis
Critical care clinicians on cirrhotic patients

How to interpret the result

Score / band	Interpretation
< 10	Lower 3-month mortality.
10–19	Moderate; transplant evaluation often warranted.
20–29	High; meaningful 3-month mortality.
≥ 30	Very high; advanced wait-list priority.

Frequently asked questions

Is this MELD-Na or MELD 3.0?

This calculator implements MELD-Na (UNOS 2016). MELD 3.0 (UNOS 2023) adds sex and albumin terms. Check your local transplant centre to confirm which version drives wait-list priority at your institution.

Why is creatinine capped at 4.0?

UNOS policy caps creatinine at 4.0 mg/dL. Patients on dialysis twice in the past week have creatinine set to 4.0 regardless of laboratory value, reflecting the equivalent prognostic burden.

Why is the sodium term only applied above MELD 11?

UNOS policy applies the sodium correction only when MELD > 11 to avoid amplifying noise at very low scores.

Does MELD-Na replace clinical judgement for transplant listing?

No. MELD-Na is one input among many — exception points, hepatocellular carcinoma criteria, frailty, comorbid burden, and centre-specific factors all matter.

Is MELD-Na useful outside transplant evaluation?

Yes — clinicians use MELD-Na to prognosticate cirrhotic patients in non-transplant contexts (TIPS candidacy, surgical risk, ICU triage). Always interpret in clinical context.

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Who this is for

How to interpret the result

Frequently asked questions

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