🫀 MELD-XI (Excluding INR)
MELD-XI is a version of the MELD score that excludes INR, designed for anticoagulated patients in whom INR is unreliable.
MELD-XI (Excluding INR)
Total bilirubin (μmol/L)
Serum creatinine (μmol/L)
When to use
Enter total bilirubin and serum creatinine; the tool applies the standard bounds and returns the MELD-XI score.
How it works
MELD-XI = 5.11 × ln(bilirubin mg/dL) + 11.76 × ln(creatinine mg/dL) + 9.44; bilirubin and creatinine <1 set to 1, creatinine capped at 4 mg/dL.
Key points
- MELD-XI is most useful in mechanical-valve, VAD, or advanced heart-failure patients where warfarin distorts the INR term (original synthesis · not guideline verbatim).
- Higher scores predict worse survival in both hepatic and cardiac populations, including pre-transplant candidates.
- Because INR is dropped, MELD-XI can underestimate coagulopathy from intrinsic liver synthetic failure.
References
- Heuman DM, et al. MELD-XI: a rational approach to sickest first liver transplantation in cirrhotic patients requiring anticoagulant therapy. Liver Transpl. 2007.
- Grimm RA, et al. MELD-XI score and outcomes in heart failure. (Review of cardiac applications.)
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.