The Child-Pugh score is also dependent on serum bilirubin, serum albumin, ascites, and encephalopathy and the MELD score includes serum bilirubin and serum creatinine apart from PT-INR.[21,28] On the contrary, ROTEM is a global coagulation test, which depends on multiple parameters with impact on hemostasis including both pro- and anticoagulation factors. This evidence concerns the gene ALB and Encephalopathy.