reMELD-Na (Eurotransplant labMELD)
Eurotransplant's refitted MELD-Na, used for liver allocation since 25 March 2025
- Eurotransplant (since 03/2025)
Sources last checked: 2026-10-13
reMELD-Na (Eurotransplant labMELD)
Eurotransplant's refitted MELD-Na, used for liver allocation since 25 March 2025
Implemented from the official Eurotransplant calculator as published on 13 Oct 2026. Allocation uses the value Eurotransplant computes from centre-reported labs; for listing, the ENIS/official calculator is authoritative. Not comparable with US MELD-Na values.
What is the reMELD-Na (Eurotransplant labMELD)?
reMELD-Na is the refitted MELD-sodium score that Eurotransplant uses as labMELD for liver allocation since 25 March 2025. Goudsmit and colleagues refitted MELD coefficients and bounds on Eurotransplant waiting-list data (Hepatology 2021) because the US formula was calibrated on a different population. This calculator follows the formula, caps and unit factors of the official Eurotransplant calculator.
When to use it
- Liver transplant candidates in Eurotransplant countries (AT, BE, HR, DE, HU, LU, NL, SI)
- Estimating how a patient's labMELD will change with new laboratory values
- Comparing prognosis across patients within the Eurotransplant system
When not to use it
- Comparison with US MELD-Na or MELD 3.0 values — the scales are not interchangeable
- Official allocation — Eurotransplant computes the binding value from reported labs
How it is calculated
reMELD-Na = 7.85 + 9.03 × ln(creatinine) + 2.97 × ln(bilirubin) + 9.52 × ln(INR) + 0.392 × (138.6 − Na) − 0.351 × (138.6 − Na) × ln(creatinine) Creatinine and bilirubin in mg/dL (µmol/L ÷ 88.42 and ÷ 17.1). Caps: creatinine 0.7–2.5 (2.5 after two dialyses in the past week), bilirubin 0.3–27, INR 1.0–2.6, sodium 120–138.6 mmol/L. Rounded to an integer, range 1–36.
Clinical pearls and limitations
- Implemented from the official Eurotransplant calculator as published on 13 Oct 2026. Allocation uses the value Eurotransplant computes from centre-reported labs; for listing, the ENIS/official calculator is authoritative. Not comparable with US MELD-Na values.
- Caps: creatinine 0.7–2.5 mg/dL, bilirubin 0.3–27 mg/dL, INR 1.0–2.6, sodium 120–138.6 mmol/L; the result is limited to 1–36.
- Adults dialysed twice in the past week get creatinine 2.5 mg/dL (221.1 µmol/L).
- Enter INR 1 when a DOAC is active, or on a vitamin K antagonist without a pre-treatment value.
- The lower caps let reMELD-Na go below 6, unlike the UNOS MELD.
Frequently asked questions
Which MELD does Eurotransplant use?
Since 25 March 2025 Eurotransplant uses reMELD-Na (refitted MELD-sodium) to calculate the labMELD.
Why is reMELD-Na lower than my MELD-Na?
The two scores have different coefficients, caps and ranges (reMELD-Na 1–36, US MELD-Na 6–40), so the numbers are not directly comparable.
Can I enter bilirubin and creatinine in µmol/L?
Yes. As in the Eurotransplant calculator, µmol/L is converted with ÷ 17.1 for bilirubin and ÷ 88.42 for creatinine.
Evidence and guidelines
- Primary source: Eurotransplant reMELD-Na calculator and Eurotransplant Manual chapter 5 (ELAS), in force since 25 March 2025; derived from Goudsmit BFJ et al. Refitting the Model for End-Stage Liver Disease for the Eurotransplant Region. Hepatology 2021;74(1):351-363 (corrected 2025).
- Goudsmit BFJ, Putter H, Tushuizen ME et al. Refitting the Model for End-Stage Liver Disease for the Eurotransplant Region. Hepatology 2021;74(1):351-363.
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<p><a href="https://medelix.ai/en/calculators/remeld-na-eurotransplant">reMELD-Na (Eurotransplant labMELD) calculator by Medelix</a></p>For healthcare professionals and medical students. These tools support, and do not replace, clinical judgement. Always check results against the original source and your local protocols.