What are King's College criteria for acetaminophen ALF?

pH 6.5 + creatinine >3.4 mg/dL (300 μmol/L) + grade III-IV encephalopathy; any single criterion for arterial pH <7.3 is sufficient for transplant consideration.

What non-acetaminophen King's College criteria indicate poor prognosis?

Non-acetaminophen ALF: INR >6.5 OR any three of: unfavorable etiology (non-A/B hepatitis, drug, Wilson), age 40 years, INR >3.5, bilirubin >300 μmol/L, jaundice to encephalopathy >7 days.

What MELD-Na score supports transplant listing in ALF?

ALF patients are given Status 1A designation (highest priority) by UNOS regardless of MELD score; MELD >35 in ALF patients with ACLF is associated with very poor outcomes without transplant.

What is the management of cerebral edema in ALF?

Elevate HOB 20-30°; mannitol for cerebral herniation signs; target Na 145-150 mEq/L (hypernatremia); continuous EEG monitoring; ICP monitoring in grade III-IV encephalopathy; minimize stimulation; avoid hypotension.

What infections complicate ALF and require prophylaxis?

Bacterial infections occur in 80% of ALF; fungal infections in 32%; routine prophylactic antifungals considered in transplant candidates; surveillance cultures and low threshold for empiric antibiotics; SBP prophylaxis if ascites present.

King's College Criteria for Acute Liver Failure Transplant Assessment

Applies King's College criteria to identify acute liver failure patients requiring urgent liver transplant listing, with separate criteria for acetaminophen-induced and non-acetaminophen causes.

Weight

Height

Clinical Guidance

BMI is a screening measure of body size, not a direct measure of body fat. The standard WHO categories are underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30).

BMI can overestimate body fat in athletes with high muscle mass and underestimate it in older adults with low muscle mass. Interpret it alongside waist circumference and clinical context rather than as a standalone diagnosis.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How to Use

Enter the values for the patient or scenario you are assessing. Applies King's College criteria to identify acute liver failure patients requiring urgent liver transplant listing, with separate criteria for acetaminophen-induced and non-acetaminophen causes. Use the king's college alf result to inform your clinical assessment.

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