MELD-Na Score — RACP Adult Medicine MCQ
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Correct answer: B — 90-day mortality without transplantation
The MELD-Na score (Model for End-Stage Liver Disease incorporating sodium) predicts 90-day mortality in patients with chronic liver disease awaiting transplantation. It is calculated from serum bilirubin, INR, creatinine, and sodium. Higher scores indicate greater illness severity and are used to prioritise organ allocation (sickest first). A MELD-Na of 22 correlates with approximately 20% 90-day mortality. It does not predict post-transplant outcomes. Exceptions (e.g., HCC, hepatopulmonary syndrome) allow MELD-Na points to be added for conditions that increase mortality independently of score.
Reference: eTG – 2025 – Gastrointestinal; TSANZ – 2024 – Liver Transplant Allocation