The international normalized ratio (INR) in the MELD score: Problems and solutions

R. J. Porte, T. Lisman, A. Tripodi, S. H. Caldwell, J. F. Trotter

Research output: Contribution to journalArticlepeer-review


The Model for End-Stage Liver Disease (MELD) score is widely used to prioritize patients for liver transplantation. One of the pitfalls of the MELD score is the interlaboratory variability in all three components of the score (INR, bilirubin, creatinine). The interlaboratory variability in the INR has the largest impact on the MELD score, with a mean difference of around 5 MELD points in most studies. During the 3rd conference on Coagulopathy and Liver disease, a multidisciplinary group of scientists and physicians discussed possible solutions for the INR problem in the MELD score with the intention to provide a constructive contribution to the international debate on this issue. Here we will discuss possible solutions and highlight advantages and disadvantages.

Original languageEnglish
Pages (from-to)1349-1353
Number of pages5
JournalAmerican Journal of Transplantation
Issue number6
Publication statusPublished - Jun 2010


  • Allocation
  • Coagulation
  • Liver transplantation
  • MELD score

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)
  • Medicine(all)


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