King’s College Criteria for Transplant Assessment
The King’s College Criteria (KCC) are the most widely used prognostic tool for identifying ALF patients who are unlikely to survive without emergency liver transplantation. They differ for paracetamol and non-paracetamol ALF:
| King’s College CriteriaParacetamol ALF — transplant if ANY of: • pH <7.30 after adequate resuscitation, OR • ALL THREE of: PT >100s (INR >6.5), creatinine >300 μmol/L, Grade III–IV encephalopathy Non-Paracetamol ALF — transplant if ANY of: • PT >100s (INR >6.5), OR • ANY THREE of: age <10 or >40; seronegative hepatitis or drug reaction; jaundice to encephalopathy >7 days; PT >50s; bilirubin >300 μmol/L |