MELD Score: What It Is, How It’s Used, and Why It Matters for Liver Disease

When your liver isn’t working right, doctors need a clear way to judge how sick you are. That’s where the MELD score, a numerical ranking used to predict survival in people with advanced liver disease. Also known as Model for End-Stage Liver Disease, it helps hospitals decide who needs a transplant most urgently. It’s not guesswork—it’s based on three simple blood tests: bilirubin, creatinine, and INR. These numbers tell doctors how well your liver and kidneys are handling toxins, clotting, and waste.

The MELD score doesn’t just measure liver damage—it predicts your risk of dying in the next three months without a transplant. A score below 10 means your liver is still managing, but a score over 20 puts you in the high-risk zone. If you hit 30 or higher, you’re often moved to the top of the transplant list. It’s a cold, hard number, but it’s fair. Unlike older systems that relied on how long you’d been waiting, MELD focuses on who’s sickest right now. That’s why it’s used across the U.S. and most of the world for liver transplant prioritization. It’s also linked to other tools like the Child-Pugh score, an older system that includes symptoms like fluid buildup and mental confusion, but MELD is more precise because it’s based on lab results alone.

What you might not realize is that your MELD score can change fast. If your bilirubin spikes after an infection, or your creatinine rises because you got dehydrated, your score goes up—and so does your chance of getting a liver. That’s why staying hydrated, avoiding alcohol, and managing infections matters more than ever when you’re on the list. It’s not just about waiting. It’s about actively protecting your numbers. Doctors also use MELD to guide other decisions, like whether to start certain medications or avoid procedures that could stress your liver further. It’s not perfect—it doesn’t account for age, nutrition, or complications like liver cancer—but it’s the best tool we have for fairness in a system where organs are scarce.

Behind every MELD score is a real person trying to stay alive. And behind every transplant list is a system trying to do the right thing with limited resources. The posts below dive into how this score connects to real-world issues: how generic drugs like immunosuppressants affect liver function after transplant, why certain medications must be avoided in advanced liver disease, how kidney problems can push your MELD higher, and what happens when insurance denies coverage for the very drugs that keep your score stable. You’ll find practical advice on managing side effects, understanding lab results, and speaking up when your care depends on a number you can’t see.