Advances in the management of acute liver failure

Table 2 King's College criteria for selecting recipients of emergency liver transplants

Acetaminophen-induced ALF	Non-acetaminophen-induced ALF
Strongly recommended list for OLT if: Arterial lactate > 3.5 mmol/L after early fluid resuscitation	List for transplantation if: INR > 6.5 and encephalopathy present irrespective of grade
List for transplantation if: Arterial pH < 7.3 or arterial lactate > 3.0 mmol/L after adequate fluid resuscitation	Or if any 3 of the following features (encephalopathy irrespective of grade) are present:
	Age < 10 yr or > 40 yr1
	Interval from jaundice to encephalopathy > 7 d1
List for transplantation if all 3 of the following occur within a 24-h period: Grade 3 or 4 hepatic encephalopathy INR > 6.5 Creatinine > 300 μmol/L	INR ≥ 3.5
	Serum bilirubin ≥ 300 μmol/L
	Unfavorable etiology, such as seronegative hepatitis, idiosyncratic drug reaction or Wilson disease

¹These criteria have not been found to be predictive of outcome in recent analyses. ALF: Acute liver failure; OLT: Orthotopic liver transplantation; INR: International normalized ratio.