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001-es BibID:	BIBFORM073359
Első szerző:	Sárváry Enikő
Cím:	Small difference in international normalized ratio may yield a significant impact on prioritizing patients listed for liver transplantation / E. Sarvary, Zs. Seregely, J. Fazakas, F. Kovacs, I. Gaal, G. Beko, J. Varga, L. Kobori, B. Nemes, D. Gorog, M. Varga, R. M. Langer, K. Monostory, J. Jaray, Zs. Gerlei
Dátum:	2010
ISSN:	0041-1345
Megjegyzések:	Priority for liver transplantation is currently based on the Model for End-stage Liver Disease (MELD) score. The aim of our study was to assess in detail the contribution of international normalized ratio (INR) differences for MELD scores because of interlaboratory variability. The samples from 92 cirrhotic patients were measured on different systems combining three coagulometers and three thromboplastin products to determine variations in INR and MELD score. The INR differences among the first four systems varied between 0 and 0.2, resulting in MELD differences of 0 to 2. The MELD scores of 92 patients changed only among 10 possible integers so that normally 2 to 10 patients shared the same MELD value. In some cases, one MELD score difference resulted in a 10 superpositioning on the waiting list. Including one more system (mechanical vs optical) into our investigations achieved a five MELD difference. Supposing an extreme situation where one patient competes with his or her lowest, all the other with their highest possible score (and visa versa), the difference may be even 20 positions, overturning the complete waiting list. In conclusion substantial interlaboratory differences in MELD score have profound clinical consequences.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Transplantation Proceedings 42 : 6 (2010), p. 2317-2322. -
További szerzők:	Seregély Zs. Fazakas János Kovács F. Gaál Ibolya Beko, G. Varga J. Kóbori László Nemes Balázs Áron (1969-) (sebész) Görög Dénes Varga M. Langer Róbert Miklós Monostory Katalin Járay Jenő Gerlei Zsuzsa
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