End-stage liver disease — UNOS allocation score (2023)
Sex
Male
Female
Total bilirubin
INR
Serum creatinine
Serum sodium (mEq/L)
Serum albumin
Dialysis ≥ 2× (or 24 h CVVHD) in the past week
Enter bilirubin, INR, creatinine, sodium, and albumin to calculate
Evidence
Original publication
Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0: the Model for End-Stage Liver Disease updated for the modern era. Adds female sex and serum albumin to MELD-Na and adds sodium–bilirubin and albumin–creatinine interaction terms; improved mortality discrimination, particularly for women.
Gastroenterology, 2021
Open source
Guideline
Adopted by OPTN/UNOS for adult liver-allocation prioritisation in July 2023, replacing MELD-Na. Bounds used here: labs ≥ 1.0; creatinine ≤ 3.0 (or 3.0 if dialysis ≥ 2×/week); albumin 1.5–3.5; sodium 125–137; final score 6–40.
Last reviewed: 2026-09
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