{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:25:31Z","timestamp":1789925131386,"version":"4.0.1"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":4048,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,8]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Priority for liver transplantation is currently based on the Model for Endstage Liver Disease (MELD) score, a mathematical function which includes the following objective variables: bilirubin, creatinine (Cr), and international normalized ratio (INR). We have noted that specific laboratory methodologies may yield consistently higher values of bilirubin, Cr, and INR. Therefore, we performed a study to determine if higher MELD scores could be obtained by utilizing laboratory methodologies selected to return higher laboratory values than standard methodologies used in our hospital\u2019s clinical laboratory. Phlebotomy was performed for routine clinical indications in 29 consecutive patients listed for liver transplantation. MELD scores were calculated using bilirubin, Cr, and INR from laboratory methods in our hospital\u2019s clinical laboratory (designated Lab #1) and from 2 other clinical laboratories (designated Lab #2 and Lab #3). The mean MELD score in our hospital\u2019s clinical laboratory (Lab #1) (13.6) was not significantly different than in Lab #2 (14.7), but in Lab #3, it was significantly higher by 20% (17.1),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .03. Virtually all of the difference in MELD score between our hospital\u2019s clinical laboratory (Lab #1) and Lab #3 could be attributed to the INR, which was significantly higher by 26% in Lab #3 (1.9) vs. Lab #1 (1.4),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .00002. Using MELD scores calculated from our hospital\u2019s clinical laboratory, the average change in priority for liver transplantation was from the 58th percentile to the 77th percentile (compared to Lab #3),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01. In conclusion, patients listed for liver transplantation at our center achieved significantly higher MELD scores and therefore a higher priority for liver transplantation by using laboratory methodologies that yield higher INR values than our hospital laboratory. The selection of laboratory methodologies may have a significant impact on MELD score. (Liver Transpl 2004;10:995-1000.)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lt.20195","type":"journal-article","created":{"date-parts":[[2004,7,23]],"date-time":"2004-07-23T13:09:29Z","timestamp":1090588169000},"page":"995-1000","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":147,"title":["Specific laboratory methodologies achieve higher model for endstage liver disease (MELD) scores for patients listed for liver transplantation"],"prefix":"10.1097","volume":"10","author":[{"given":"James F.","family":"Trotter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Brimhall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russ","family":"Arjal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-6-20250326","doi-asserted-by":"crossref","first-page":"9196","DOI":"10.1053\/gast.2003.50016","article-title":"Model for end-stage liver disease (MELD) and allocation of donor liver.","volume":"124","author":"Wiesner","year":"2003","journal-title":"Gastroenterology"},{"key":"R4-6-20250326","doi-asserted-by":"crossref","first-page":"282288","DOI":"10.1001\/archinte.1994.00420030084008","article-title":"The international normalized ratio.","volume":"154","author":"Hirsh","year":"1994","journal-title":"Arch Intern Med"},{"key":"R6-6-20250326","doi-asserted-by":"crossref","first-page":"13921394","DOI":"10.1002\/hep.510240613","article-title":"Prothrombin time in liver failure: time, ratio, activity percentage, or international normalized ratio.","volume":"24","author":"Robert","year":"1996","journal-title":"Hepatology"},{"key":"R7-6-20250326","first-page":"727730","article-title":"Assessment of the validity of the INR system for patients with liver impairment.","volume":"71","author":"Kovacs","year":"1994","journal-title":"Thromb Haemost"},{"key":"R8-6-20250326","doi-asserted-by":"crossref","first-page":"255261","DOI":"10.1016\/S0049-3848(98)00217-5","article-title":"Comparative studies of rabbit and human recombinant tissue factor reagents.","volume":"94","author":"Denson","year":"1999","journal-title":"Thromb Res"},{"key":"R11-6-20250326","first-page":"14511455","article-title":"Multicenter evaluation of lyophilized and deep-frozen plasmas for assignment of the International Normalized Ratio.","volume":"82","author":"van den Besselaar","year":"1999","journal-title":"Thromb Haemost"},{"key":"R12-6-20250326","first-page":"633636","article-title":"Monitoring oral anticoagulant treatment from plasma stored for up to 48 hours and frozen plasma.","volume":"84","author":"Grau","year":"1999","journal-title":"Haematologica"},{"key":"R13-6-20250326","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/00001721-200106000-00002","article-title":"Stability of coagulation proteins in frozen plasma.","volume":"12","author":"Woodhams","year":"2001","journal-title":"Blood Coagul Fibrinolysis"},{"key":"R14-6-20250326","doi-asserted-by":"crossref","first-page":"734735","DOI":"10.2460\/ajvr.2001.62.734","article-title":"Effect of storage conditions on hemostatic parameters of canine plasma obtained for transfusion.","volume":"62","author":"Iazbik","year":"2001","journal-title":"Am J Vet Res"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.20195","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/01445473-200408000-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:37:40Z","timestamp":1786048660000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01445473-200408000-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,8]]},"references-count":9,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2004]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.20195","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2004,8]]}}}