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King´s College Hospital Criteria for Liver Transplantation in Fulminant Hepatic Failure

Acetaminophen-induced disease

Arterial pH <7.3 (irrespective of the grade of encephalopathy)


Grade III or IV encephalopathy, and

Prothrombin time >100 seconds, and

Serum creatinine >3.4mg/dl (301 μmol/L)

All other causes of fulminant hepatic failure

Prothrombin time >100 seconds (irrespective of the grade of encephalopathy)


Any three of the following variables (irrespective of the grade of encephalopathy)

  1. Age <10 years or >40 years

  2. Etiology: non-A, non-B hepatitis, halothane hepatitis, idiosyncratic drug reactions

  3. Duration of jaundice before onset of encephalopathy >7 days

  4. Prothrombin time >50 seconds

  5. Serum bilirrubin >18 mg/dl (308 μmol/L)


Related Criteria

Appropriate Indications for Upper Gastrointestinal Endoscopy (UGE)

Diagnostic Criteria for Zollinger-Ellison Syndrome (ZES)

Diagnostic Criteria for Autoimmune Hepatitis (AIH)

Diagnostic Criteria for Wilson's disease

Severity Criteria for Acute Pancreatitis




  1. O'Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989 Aug;97(2):439-45. [Medline]

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Created: Jan 29, 2008
Last Modified: 10/17/2010

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