OPTN Calculated MELD 3.0: Policy 9.1.D Formula and Limits

Source lock

This route is locked to OPTN Calculated MELD 3.0 under Policy 9.1.D, implemented July 13, 2023. The public OPTN policy and calculator pages were reviewed again on July 24, 2026. It is not the historical MELD or MELD-Na formula.

The permanent URL retains the legacy misspelling in meld-liver-transpplant for compatibility.

Two registration-age branches

Candidates registered at age 18 or older use the adult equation. Its inputs are bilirubin, sodium, INR, creatinine, albumin, dialysis status, and the explicit OPTN sex for purposes of adult MELD calculation selection. The calculator does not infer that field from gender or birth sex.

Candidates currently age 12 or older who were registered before age 18 use the policy's adolescent branch. That branch omits the sex term and uses its own constant. Turning 18 later does not switch the branch.

Policy lab handling

The implementation first validates the official raw ranges, then normalizes SI values when selected. It floors bilirubin, INR, and creatinine at 1 mg/dL-equivalent, caps creatinine at 3 mg/dL, clamps sodium to 125–137 mmol/L, and clamps albumin to 1.5–3.5 g/dL.

A creatinine value of 3 mg/dL is used when the candidate had at least two dialysis treatments or at least 24 hours of continuous veno-venous hemodialysis within the seven days before the creatinine test.

Natural-log terms use full precision. The raw score is clamped to 6–40 and rounded to the nearest whole integer only at the end.

Deliberate limits

The result stops at calculated MELD. It does not calculate Status 1, an exception score, HCC exception points, median MELD at transplant, final match priority, listing eligibility, mortality percentages, or a transplant recommendation. Those require the complete current OPTN workflow and specialist review.

Primary sources

1. OPTN Policies, Policy 9.1.D
2. Updates to medical urgency scoring effective July 13, 2023
3. OPTN MELD calculator
4. MELD 3.0 FAQ
5. Kim et al., MELD 3.0