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MELD 3.0 is a more accurate predictor of mortality in decompensated cirrhosis than MELD and MELD-Na

Amal Khsiba1, Sahar Chtioui1, Moufida Mahmoudi1

  • 1Gastroenterology department, Hospital of Nabeul, Faculty of medecine of Tunis, University of Tunis el Manar, Tunis, Tunisia.

La Tunisie Medicale
|July 22, 2026
PubMed
Abstract

Insights

The MELD 3.0 score accurately predicts mortality in Tunisian patients with decompensated cirrhosis, outperforming MELD and MELD-Na. A score of 24 or higher indicates priority for liver transplantation.

Area of Science:

  • Hepatology
  • Transplant Medicine
  • Medical Statistics

Background:

  • Prognostic scores are crucial for organ allocation in cirrhosis patients.
  • Evaluating the efficacy of existing scores in specific patient populations is essential.

Purpose of the Study:

  • To assess the performance of MELD, MELD-Na, and MELD 3.0 in predicting mortality.
  • To evaluate these scores in Tunisian patients with decompensated cirrhosis.

Main Methods:

  • Retrospective study of 152 decompensated cirrhosis patients in Tunisia.
  • Analysis of 3-month mortality using MELD, MELD-Na, and MELD 3.0 scores.
  • Calculation of Area Under the Receiver Operating Characteristic Curve (AUROC) for each score.

Main Results:

  • MELD 3.0 demonstrated the highest AUROC (0.850) for predicting 3-month mortality.
  • MELD-Na (0.841) also showed improved performance over MELD (0.786).
  • A MELD 3.0 cut-off of 24 achieved 68% sensitivity and 88% specificity for mortality.

Conclusions:

  • MELD 3.0 is a superior predictor of mortality in this cohort compared to MELD and MELD-Na.
  • A MELD 3.0 score ≥24 can identify patients needing prioritized liver transplant listing.
Keywords:
CirrhosisLiver transplanationPrognosismortality

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