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Clinical usefulness of international normalized ratio calibration of prothrombin time in patients with chronic liver disease

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Abstract

The international normalized ratio (INR) may not be directly applicable to patients with liver disease. We aimed to establish an alternative INR calibration system for patients with liver disease and to evaluate the effect of their use in chronic liver disease patients. Eighty-two patients with liver cirrhosis (LC) were included, and their prothrombin times (PTs) were measured by using 5 commercial thromboplastins. Each of the thromboplastins was also assigned an international sensitivity index (ISIliver) by the plasmas from LC patients. INRvka, INRliver, model for end-stage liver disease (MELD)vka, MELDliver, Child-Pugh (Child)vka, and Childliver scores were calculated. The coefficient of variance of INRvka was significantly larger than that of INRliver (P < 0.01). The mean difference in INRvka between the thromboplastins was also significantly larger than that in INRliver (P < 0.01). The total mean MELDliver score was higher than the total mean MELDvka score. The mean difference between the MELDvka and MELDliver scores (MELD score ≥15) was 3.2 %. We reconfirmed that the use of the alternative calibration system described herein for patients with liver disease may resolve the variability of INR measurement. Our data suggest that we would need to reevaluate the correlation between Child-Pugh class, MELD score, and clinical prognosis by using INRliver for patients with LC.

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Acknowledgments

The Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (NRF-2010-0024678), supported this work.

Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Laboratory Medicine, Chung-Ang University College of Medicine, Heukseok-ro 102, Dongjak-gu, Seoul, 156-755, Republic of Korea

    Jun Hyung Lee, Oh Joo Kweon, Mi-Kyung Lee & Hye Ryoun Kim

  2. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea

    Hyun Woong Lee & Hyung Joon Kim

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  1. Jun Hyung Lee
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  2. Oh Joo Kweon
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  3. Mi-Kyung Lee
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Correspondence to Hye Ryoun Kim.

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Lee, J.H., Kweon, O.J., Lee, MK. et al. Clinical usefulness of international normalized ratio calibration of prothrombin time in patients with chronic liver disease. Int J Hematol 102, 163–169 (2015). https://doi.org/10.1007/s12185-015-1820-2

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  • DOI: https://doi.org/10.1007/s12185-015-1820-2

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