High HVPG and low SNa may identify high-risk patients with low MELD scores.

In conclusion, persistent ascites and low serum sodium identify patients with cirrhosis with high mortality risk despite low MELD scores.

Prognostic significance of persistent ascites and low serum sodium for low MELD score patients was confirmed in the validation group.

Modifying MELD, by including points for persistent ascites and low serum sodium, improved prediction of early pretransplant mortality in low MELD score patients.

Survivors showed young age, shorter duration from diagnosis to corticosteroid therapy, low MELD score, and absence of hepatic encephalopathy at the time of corticosteroid administration.