Meanwhile, the number of patients presented with HE (<.0001), the MELD (P = .006), MELD‐Na score (P = .009) and COSSH‐ACLF score (P = .049), albumin level (P = .011), and INR value (P < .0001) were significantly less in the derivation group compared to the validation group. This evidence concerns the gene ALB and hereditary elliptocytosis.