Units: Conventional Standard

Kings College Criteria

Paracetamol induced acute liver failure
a. An arterial ph of less than 7.3, irrespective of grade of encephalopathy Yes
OR all of the following three
a. A prothrombin time (PT) greater than 100 seconds ( approx INR> 6.5) Yes
b. Patients must have grade III or IV encephalopathy. Yes
c. And a serum creatinine concentration greater than 3.4 mg/dl
c. And a serum creatinine concentration greater than 301 µmol/L
 Yes
Urgent Liver Transplant Indicated :  
Non-paracetamol related acute liver failure
a. Either A Prothombin time (PT) greater than 100 seconds ( approx INR> 6.5) irrespective of the grade of encephalopathy. Yes
Any three of the following five variables
a. Age < 10years > 40 years Yes
b. Aetiology:Non-A, Non-B hepatitis, idiosyncratic drug reactions Yes
c. Duration of jaundice before development of encephalopathy > seven days Yes
d. Prothombin time (PT) greater than 50 seconds ( approx INR >3.5) Yes
e. Serum bilirubin > 18 mg/dl
e. Serum bilirubin > 300 µmol/L
 Yes
Urgent Liver Transplant Indicated :
 

Grades of Hepatic Encephalopathy

Grade 1 - Inverted sleep pattern; forgetfulness, agitation, irritability, apraxia
Grade 2 - Lethargy; Disorientation for time or place, Subtle personality change; Asterixis, ataxia
Grade 3 - Somnolence but rousability, Disorientation as regards place; Asterixis, hyperactive reflexes, Babinski signs, muscle rigidity
Grade 4 - Coma (unresponsive to verbal or noxious stimuli)

Disclaimer:
The calculators allow you to enter patient specific information to calculate a simple score. All information is provided for educational purposes only. This information is not intended to replace clinical judgement. All calculations must be rechecked and should not be used alone to guide patient care. The user assumes sole responsibility for any decisions or action taken based on the information contained here.