BACKGROUND & AIM: Patients with end-stage liver disease require valid 
estimations of mortality for organ allocation and risk stratification. The model 
of end-stage liver disease (MELD) score is used for this purpose in most 
countries and incorporates bilirubin, International Normalized ratio, and 
creatinine. The aim of this study was to evaluate the comparability of 
creatinine results from different routine assays in the serum samples of 
patients with liver cirrhosis.
METHODS: Residual material from 60 serum samples was available from patients in 
different stages of liver cirrhosis. Four centers participated; each center 
analyzed the samples with Jaffé-based and enzymatic routine assays in parallel. 
In addition, an accredited calibration laboratory certified the panel of samples 
by an internationally accepted reference measurement procedure (RMP) based on 
isotope dilution mass spectrometry (ID-MS). This method served as the 
independent reference.
RESULTS: All routine methods displayed a high correlation to the RMP (r ≥0.937, 
p<0.001). Two enzymatic and two Jaffé-based methods provided results that were 
all within a ±20% range of the RMP. The other methods showed deviations >20% in 
up to 27% of the samples. The enzymatic methods were systematically lower, 
whereas the Jaffé-based methods were systematically higher (p<0.001). The 
resulting MELD scores differed from 0 to 4 points.
CONCLUSIONS: There are systematic deviations from the RMP. Jaffé-based assays 
gave higher results, whereas the enzymatic-based assays gave lower results 
compared to the results of the RMP. The comparability of results is limited and 
could be disadvantageous to patients listed for liver transplantation.