# MELD-Na (UNOS 2016) Calculator
> Free MELD-Na (UNOS 2016) calculator for end-stage liver disease prognostication and transplant list prioritisation. Handles dialysis and sodium clamps per UNOS policy. Clinician decision support.

## Overview

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.

## 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 | Meaning |
|---|---|
| < 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. |

## Cited source

**UNOS / OPTN MELD-Na Policy (2016)** (2016) — UNOS / OPTN

_Primary publication:_ Kim WR et al., NEJM 2008 (Hyponatraemia and mortality in cirrhosis)

## FAQs

### 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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_Rounds AI is a citation-first clinical AI assistant. It supports clinical reasoning by surfacing cited information and is not a substitute for independent clinical judgement._