King's College Criteria for Acute Liver Failure
Identifies patients with acute liver failure (ALF) who require urgent liver transplant listing. Separate criteria for paracetamol (acetaminophen) and non-paracetamol aetiology.
Score interpretation
KCC not met. Spontaneous recovery possible, but close monitoring required.
→ Intensive monitoring in specialist liver unit. Reassess every 6–12 hours. Re-apply KCC if deterioration.
KCC met. High predicted mortality without liver transplantation (>90%).
→ URGENT liver transplant listing. Contact regional transplant centre immediately. Intubate and support organs. N-acetylcysteine infusion if paracetamol-related (even >24 hours). Dialysis if renal failure.
Interpretation bands for the King's ALF. Apply clinical judgement and local guidance.
References
- O'Grady JG et al. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989;97(2):439-445.
- Bernal W et al. Acute liver failure. Lancet. 2010;376(9736):190-201.
Related
Curated clinical cross-links plus same-class fallbacks.
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
- Mannitol (Osmotic Diuretic — Renal/Neurological) · Acute Oliguric Renal Failure / Raised ICP
- Acetylcysteine (N-acetylcysteine — Paracetamol Overdose) · Mucolytic / Hepatoprotective Antidote
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Vericiguat · Heart Failure
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.