Anja Dodevska 
Nurse conversion chart
What a nurse conversion chart covers A nurse conversion chart groups the unit co...
1
Last Updated: Nov 4, 2026
Clinical guides
MELD score: MELD 3.0 formula, ranges and free worksheet
Free PDF 2 pages, print-ready Clinician-reviewed
The MELD score (Model for End-Stage Liver Disease) grades the severity of chronic liver disease on a scale of 6 to 40. It estimates a patient's risk of death within 90 days, and higher scores mean earlier priority for a donor liver. The original 2002 equation uses bilirubin, INR and creatinine. MELD 3.0, which US liver allocation has used since July 13, 2023, adds sodium, albumin and sex. The free worksheet takes your team through the MELD 3.0 bounds, equation and result, step by step.
Template details
- Template type
- Worksheet
- Format
- Printable PDF, 2 pages
- Sections
- 4 sections
- Fields to complete
- 12 fields
- Best for
- Clinical guides
Free download
Download your free MELD 3.0 score worksheet
A two-page MELD 3.0 worksheet that opens with the input bounds and a dated field for each of five lab values. The equation follows, split into terms. It closes with the rounded score, the next recertification date and space for clinical context.
What’s inside
- ABOUT THIS SCORE
- RECORD THE LABORATORY VALUES
- THE EQUATION
- RESULT
Generate it. Send it. File it automatically.
Turn this template into a Smart Form
Start from scratch, or upload this PDF or any form you already use, and Pabau's AI Form rebuilds it with tick boxes, text fields and a signature. Attach it to the treatment once, and every patient gets it on time.
- Generate with AI from a PDF, Word file or photo
- Precare before the visit, aftercare after checkout
- Signed forms saved to the patient record
Why practices run their forms on Pabau
Bring your forms across fast
AI Form rebuilds the consent, history and aftercare forms you already use. You review each one, then publish.
Save hours every week
Patients complete forms on their phone before they arrive, so the front desk stops retyping paper.
Stay audit-ready
Every signed form is versioned and attached to the treatment record, ready when you need it.
Ask patients once
Set how long a consent stays valid. Returning patients skip forms they have already signed.
Supports HIPAA and GDPR compliance AES-256 encryption 4.8 on G2 4.7 on Capterra Trusted by 4,000+ practices worldwide
Key takeaways
The MELD score grades chronic liver disease from 6 to 40, and a higher score means a higher 90-day mortality risk.
MELD 3.0 replaced MELD-Na in US liver allocation on July 13, 2023.
MELD 3.0 adds sodium, albumin and sex to bilirubin, INR and creatinine, and caps creatinine at 3.0 mg/dL.
Two interaction terms and the final constant of 6 are the parts of the MELD 3.0 equation most often left out.
Record every lab value with its draw date, so another clinician can reproduce the score.
Found our content helpful?
What is the MELD score?
The MELD score (Model for End-Stage Liver Disease) is a number from 6 to 40 that grades how severe chronic liver disease is. It estimates the risk of death within 90 days, and US transplant programs use it to rank candidates for a donor liver.
- Liver function: Bilirubin and INR both reflect how well the liver is working.
- Kidney function: Serum creatinine signals renal impairment, which often accompanies advanced liver disease.
- Patient factors: MELD 3.0 also uses serum sodium, serum albumin and the patient’s sex.
- Output: One whole number from 6 to 40.
The original MELD formula and its inputs
The original MELD equation was adopted for US liver allocation in 2002. It combines the natural logarithms of serum bilirubin (mg/dL), INR and serum creatinine (mg/dL).
MELD = 3.78 × ln[bilirubin] + 11.2 × ln[INR] + 9.57 × ln[creatinine] + 6.43
The result is rounded to a whole number. Scores below 6 are rounded up to 6, and scores above 40 are capped at 40.
MELD-Na and MELD 3.0: What each version adds
Two later versions build on the original equation, and each one changed US allocation when it went live. The comparison below shows which inputs and bounds each version uses.
- MELD-Na: Adds serum sodium, because low sodium independently predicts poorer outcomes in cirrhosis. It was the primary US allocation score from January 2016 until July 2023.
- MELD 3.0: Adds albumin and sex, plus two interaction terms, and lowers the creatinine cap to 3.0 mg/dL. Kim and colleagues published it in Gastroenterology in December 2021, and OPTN implemented it in 2023.
Confirm which version your program uses before you calculate. Not every country has adopted MELD 3.0, so US practice may not apply where you work.
How MELD 3.0 is calculated
MELD 3.0 uses five lab values and the patient’s sex. Bound each value first, then work through the equation one term at a time.
The equation adds nine terms, listed here in the order the worksheet works through them.
- 1.33, for female patients only
- + 4.56 × ln[bilirubin]
- + 0.82 × (137 − sodium)
- − 0.24 × (137 − sodium) × ln[bilirubin]
- + 9.09 × ln[INR]
- + 11.14 × ln[creatinine]
- + 1.85 × (3.5 − albumin)
- − 1.83 × (3.5 − albumin) × ln[creatinine]
- + 6
The two subtracted terms are the interactions. The albumin and creatinine term makes albumin count for less as creatinine rises. Leaving out either interaction, or the final 6, gives the wrong score.
Round the total to a whole number and hold it between 6 and 40. Some candidates were listed before age 18 and are now 12 or older. For them, drop the sex term and use a constant of 7.33 in place of 6. Children under 12 are scored with PELD-Cr.
How to fill in the worksheet
The worksheet gives every calculation the same structure. That keeps records comparable across clinicians.
- Record the patient’s name, medical record number and the date.
- Enter each lab value after bounding it, with the date it was drawn.
- Mark whether the patient had dialysis, or 24 hours of CVVHD, twice in the past week.
- Tick the sex term, then fill in the value and working for each term of the equation.
- Round the total, and record the score, the score date and the next recertification date.
- Note the clinical context and any exception points requested.
Teams that draft notes with AI should still check every value against the source labs before the note is signed.
How to read the result
Higher scores indicate more severe liver disease and a higher short-term risk of death. Use the bands below as a reading aid, not as a prognosis.
Mortality figures for each band vary by study, population and MELD version. Cite the specific validation study whenever you quote a percentage.
Listing thresholds vary by transplant program. A score of 15 is often cited as a reference point, but confirm current OPTN policy before acting on any threshold.
MELD score and liver transplant allocation
In the United States, the Organ Procurement and Transplantation Network (OPTN) uses MELD 3.0 to rank liver candidates aged 12 and older. Candidates are recertified on a schedule that tightens as the score rises, which is why the worksheet records the next due date.
The OPTN allocation policy sets the rules, and those rules change over time. Check the current criteria directly.
The UK works differently. NHS Blood and Transplant uses the UKELD score to judge eligibility for the liver waiting list, and a separate Transplant Benefit Score to allocate livers.
Limitations and common calculation errors
The MELD score is a useful estimate, but it has blind spots that affect how you read it.
- Lab timing: Values drawn on different days can produce a score that no longer reflects the patient.
- Creatinine from other causes: Acute kidney injury unrelated to the liver can raise creatinine and push the score up.
- Skipped bounds: Missing a 1.0 floor, the sodium or albumin range, or the creatinine cap produces an incorrect result.
- Mixed versions: Applying the original 4.0 mg/dL creatinine cap inside a MELD 3.0 calculation overstates the creatinine term.
- Portal hypertension: None of the versions includes a measure of portal hypertension.
- Creatinine sex bias: Women have lower creatinine at the same kidney function, and MELD 3.0 was designed partly to correct this.
What a complete MELD record includes
A complete record lets another clinician reproduce the score. Store each element with its date and source.
- Each lab value, its unit and its draw date.
- Any floor, range or creatinine cap applied, with the reason.
- The final score, the version used and the calculation date.
- The next recertification date.
- The clinical decision the score informed.
The narrative around the score follows the same rules as any clinical note, covered in our guide to safer clinical note writing.
In the US, HHS HIPAA guidance governs how these records are stored and shared.
Pro Tip
Ask a second team member to recalculate the score from the recorded lab values before the note is signed. A second pass catches common errors, such as a sodium value entered in the creatinine field or a missed dialysis flag. Keep the worksheet with the note so the calculation can be reproduced at review. This takes only a few minutes and protects both the patient and the clinician.
How Pabau keeps MELD calculations reproducible
Many hepatology teams calculate MELD in a web calculator and type the result into the note. The bounded inputs, the version used and the draw dates rarely travel with it.
Pabau is the practice management platform we build, used as software for private GPs and by specialist practices. Its medical records software stores the worksheet fields as a form in the patient file, so each lab value, bound and score keeps its date.
Pabau Scribe, our AI scribe, drafts the clinical note from the consultation. A clinician still checks every lab value against the source results before signing.
At the next recertification, the previous score and its inputs are already in the patient file. The trend is visible without searching through old lab reports.
Keep every MELD calculation reproducible
Pabau stores MELD worksheets, dated lab values and clinical notes in one patient file. Book a demo to see how it supports hepatology documentation.
Conclusion
Use MELD 3.0 for any US allocation calculation made since July 13, 2023, and record the version beside the score. A result built on the old 4.0 mg/dL creatinine cap, or without the interaction terms, will not match the one your transplant center reports.
The arithmetic is the easy part. What protects the patient is a record another clinician can rebuild from the bounded inputs and their dates. Book a demo to see how Pabau keeps each MELD worksheet, lab value and note together in the patient file.
Continue your research
Assessing the right upper quadrant? Gallbladder physical exam covers the bedside signs, technique and documentation for gallbladder disease.
Documenting the abdominal exam? Abdominal exam documentation gives you a free template with worked examples.
Planning care for biliary disease? Cholecystitis nursing care plan sets out nursing diagnoses, goals and interventions in one form.
Frequently asked questions
What is a normal MELD score?
No single value is normal, because the scale runs from 6 (least severe) to 40 (most severe). Interpret each result against the patient’s prior scores and clinical picture.
How is MELD-Na different from the original MELD score?
MELD-Na adds serum sodium to the original calculation, because low sodium predicts poorer outcomes in cirrhosis. It was the primary US allocation score from January 2016 until MELD 3.0 replaced it in July 2023.
At what score does a patient get a liver transplant?
No single cut-off applies everywhere. Listing criteria are set by transplant programs and OPTN policy, so check the current rules for your program and region.
Is MELD 3.0 used everywhere?
No. OPTN implemented MELD 3.0 in US liver allocation in 2023, but not every country has followed. Confirm which version your local program uses.
Why does MELD 3.0 add points for female patients?
Creatinine runs lower in women at the same level of kidney function, so earlier versions understated how sick they were. The 1.33-point sex term in MELD 3.0 was designed partly to correct that bias.
Can I use this worksheet to manage patients directly?
No. The worksheet supports calculation and documentation only. It does not replace clinical judgment or local protocols, and a qualified clinician must review every score.
Found our content helpful?
