patients who have hyponatremia typically have more severe liver disease than their MELD scores suggest. We are not close to adoption of a MELD-Na system nationally. patients often have problems with ascites and renal dysfunction.
I'm currently listed with a MELD of 21 and frequent bouts of hyponatremia. My transplant center has applied to UNOS for a MELD exception for the low sodium levels, but told me exemptions are rare except in cases involving HCC. My sodium levels have recently been as low as 115 which required hospitalization and treatment. Good luck to you, I'll let you know if I get an exemption.
I just found out that I was awarded an exepmtion to hyponatremia. UNOS gave me 7 additional MELD points for the low sodium. Hope it helps accelerate things as I have been hospitalized 3 times in the past month for dangerously low sodium levels. Good luck to you.