What is a Normal MELD 3.0 Score?
A "normal" MELD 3.0 score does not exist in the traditional sense, as MELD scores are designed to assess severity of liver disease rather than define normalcy; however, the lowest possible MELD 3.0 score is 6, which represents minimal laboratory abnormalities and the lowest predicted mortality risk in patients with liver disease. 1
Understanding MELD 3.0 Score Range
The MELD 3.0 score operates on a continuous scale:
- Minimum score: 6 - This represents the floor of the MELD scale and indicates the lowest detectable severity of liver disease based on laboratory parameters 1
- Maximum score: 40 (traditionally capped) - Though recent evidence suggests scores can exceed 40 with progressively worsening mortality 2
- The score correlates with 3-month mortality, ranging from approximately 90% survival at MELD 6 to 7% survival at MELD 40 1
Clinical Context: What MELD 3.0 Measures
MELD 3.0 is not a test of "normal" liver function but rather a prognostic tool that incorporates:
- Serum bilirubin 3
- International normalized ratio (INR) 3
- Serum creatinine (capped at 3.0 mg/dL) 3
- Serum albumin (new addition in MELD 3.0) 3
- Patient sex (new addition in MELD 3.0, with women receiving approximately 1.3 additional points) 3
Clinical Significance of Low MELD Scores
Patients with MELD scores <15 are considered lower risk and typically do not meet criteria for liver transplant listing 4
- These patients require management focused on complications of cirrhosis rather than urgent transplant evaluation 4
- Regular monitoring is indicated to detect disease progression 4
A MELD score ≥15 represents the threshold for high-risk disease requiring immediate transplant evaluation 4, 1
Important Caveats
The concept of "normal" is misleading in this context because:
- MELD scores are calculated in patients with known or suspected liver disease 1
- Even the minimum score of 6 reflects some degree of laboratory abnormality in bilirubin, INR, or creatinine 1
- Healthy individuals without liver disease would not typically have MELD scores calculated, as the score has no validated role in screening asymptomatic populations 5
MELD 3.0 was specifically developed to improve mortality prediction and reduce gender disparities in liver transplant allocation, showing better discrimination than MELD-Na (concordance statistic 0.869 vs 0.862) 3