MELD Scores & Liver Transplant
Where am I on the LIST?
What is MELD? : MELD stands for Model of End Stage Liver disease. It is a number value
that indicates the severity of your liver disease. The value ranges from 6 to 40. The closer you
are to 40, the more likely you are to die if you do not get a transplant.
How is it used? : When a liver becomes available from a deceased donor, MELD scores are
used to decide who that liver goes to. In general, livers go to the patient with the highest MELD
score that is the same blood type as the donor.
How is the MELD score calculated? : MELD scores are calculated using the patient’s blood
tests. Specifically, the total bilirubin, creatinine, INR, and sodium are used to calculate the
MELD score. Albumin is also needed to update the MELD score.
Can I calculate my MELD score? : Yes. There are many websites available with MELD
calculators. These include: http://optn.transplant.hrsa.gov (MELD is under the Resources tab)
and http://www.uwhealth.org/transplant/liver-transplant/10363 (Under Patient Education
How does my MELD score get updated? : You typically will receive a letter in the mail
instructing you that your MELD score is due to be updated. This letter serves as an order for you
to take to your local lab to have your labs drawn. After your lab faxes us the results, we enter
your lab scores into the UNOS (United Network for Organ Sharing) computer system.
What labs are needed to update my MELD? : In order to update your MELD in UNOS, the
following lab tests are required:
ξ Total bilirubin
We cannot update your score in UNOS unless we have ALL FIVE of these results. In addition,
if you have a MELD exception for something like cancer, additional labs and testing are needed.
Your transplant coordinator will tell you what is needed to update your score.
How often do you have to update my MELD? : UNOS has rules for how often MELD scores
have to be updated. This depends on how high your score is. The higher the score, the more
often we have to update it. See the table below:
MELD SCORE Update DUE: LAB VALUES MUST
25 or greater Every 7 days 48 hours old or less
24-19 Every 30 days 7 days old or less
18-11 Every 90 days 14 days old or less
< or = 10 Every year 30 days old or less
What happens if you don’t update my MELD score on time?: If we do not update your score
by the time frame outlined above, your MELD score will automatically drop to 6 in UNOS.
With a score of 6, you would not be eligible for a liver should an organ became available.
Therefore, it is extremely important that we update your score when it is due.
How often can you update my score? : We can update your score as often as needed. Anytime
you become sicker, if your score is higher, we can update it as long as we receive the lab tests
needed to do so.
What can I do to help? :
ξ Know when your MELD score needs to be updated
ξ Check your mail regularly for MELD lab orders
ξ Make plans to go to the lab to have the tests drawn in a timely fashion
ξ Be sure the lab draws ALL FIVE tests needed to update the score
ξ Be sure the lab faxes the results of the test to the transplant program in a timely manner
ξ Have your MELD labs drawn anytime you feel sicker. This includes anytime you go
into the ER or hospital
ξ Carry the provided laminated card in your wallet & show it to the doctors at the ER or
ξ Call your transplant coordinator anytime you have questions about your MELD score or
what is needed.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©12/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7748.