Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Feb;13(1):63-66.
doi: 10.1016/j.cld.2008.09.001.

The international normalized ratio of prothrombin time in the model for end-stage liver disease score: a reliable measure

Patrick S Kamath  1 , W Ray Kim  2
Affiliations

The international normalized ratio of prothrombin time in the model for end-stage liver disease score: a reliable measure

Patrick S Kamath et al. Clin Liver Dis. 2009 Feb.

Abstract

The Model for End-stage Liver Disease (MELD) has been demonstrated to be an excellent predictor of survival in patients who have end-stage liver disease. It is derived from the international normalized ratio (INR) of prothrombin time, serum creatinine, and serum total bilirubin. The major use of the MELD score is to prioritize allocation of organs for liver transplant among patients who have chronic liver disease. Virtually every study that has looked at the MELD score as a predictor of survival has demonstrated that the MELD score using the INR with international sensitivity index calibrated for patients on warfarin has a 'c' statistic of approximately 0.8, indicating excellent discrimination.

PubMed Disclaimer

References

    1. Malinchoc M, Kamath PS, Gordon F, Peine C, et al. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864–71. - PubMed
    1. Kamath PS, Wiesner R, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–70. - PubMed
    1. Wiesner R, Edwards E, Freeman R, et al. United Network for Organ Sharing Liver Disease Severity Score Committee. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124:91–96. - PubMed
    1. van den Besselaar A, Barrowcliffe T, Houbouyan-Reveillard L, et al. Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the ISTH. Guidelines on preparation, certification, and use of certified plasmas for ISI calibration and INR determination. J Thromb Haemost. 2004;2:1946–53. - PubMed
    1. Trotter J, Brimhall B, Arjal R, et al. Specific methodologies achieve higher model for end-stage liver disease (MELD) scores for patients listed for liver transplantation. Liver Transplantation. 2004;10:995–1000. - PubMed