MELD 3.0
MELD 3.0 adds sex and albumin to MELD-Na and updates the interactions between the variables. It was adopted for liver allocation in the United States in 2023. Australia and New Zealand use MELD-Na; see the MELD-Na calculator.
Not yet checked against the current source
Taken from Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0. Gastroenterology, 2021;161(6):1887-1895. Nobody has checked it against the current source since. Confirm anything you prescribe from it. Applies to United States liver allocation since 2023. Australia and New Zealand use MELD-Na.. Open the source.
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How it is worked out
MELD 3.0 = 1.33 × female + 4.56 × ln bilirubin + 0.82 × (137 − Na) − 0.24 × (137 − Na) × ln bilirubin + 9.09 × ln INR + 11.14 × ln creatinine + 1.85 × (3.5 − albumin) − 1.83 × (3.5 − albumin) × ln creatinine + 6, rounded, with a maximum of 40. Bilirubin and creatinine are in mg/dL and albumin in g/dL. Bilirubin, INR and creatinine below 1.0 are set to 1.0; creatinine above 3.0, or dialysis, is set to 3.0; sodium is bounded to 125 to 137 and albumin to 1.5 to 3.5 g/dL.
Reference
Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0: the Model for End-Stage Liver Disease updated for the modern era. Gastroenterology. 2021;161(6):1887-1895.