Kings College Criteria for Paracetamol Toxicity
King's College Hospital criteria for liver transplantation in paracetamol-induced acute liver failure. Identifies patients unlikely to survive without transplantation.
Score interpretation
→ King's Criteria met: Arterial pH <7.30. Urgent liver transplant referral NOW. Poor prognosis without transplant (~85% mortality). Continue N-acetylcysteine; ICU; hepatology and transplant team; manage ICP, coagulopathy, renal failure.
→ King's Criteria met: All 3 present simultaneously (PT, creatinine, encephalopathy). Urgent liver transplant referral. Provide maximum supportive therapy. Contact regional transplant centre immediately. Continue N-acetylcysteine regardless of timing.
→ King's Criteria not met. Continue supportive management; N-acetylcysteine infusion (continue even late); close monitoring (4-hourly PT, creatinine, pH, glucose, lactate, HE grading); repeat assessment if deterioration.
Interpretation bands for the Kings College Criteria. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Maddrey's Discriminant Function for Alcoholic Hepatitis · Hepatology
- Lille Model for Alcoholic Hepatitis · Hepatology
- NAFLD Fibrosis Score · Hepatology
- AST to Platelet Ratio Index (APRI) · Hepatology
- West Haven Criteria for Hepatic Encephalopathy · Hepatology
- EVendo Score for Oesophageal Varices · Hepatology
- Acetylcysteine (N-acetylcysteine — Paracetamol Overdose) · Mucolytic / Hepatoprotective Antidote
- Acetylcysteine (N-acetylcysteine — NAC) · Antidote — paracetamol overdose / Hepatoprotectant
- Acetylcysteine · Mucolytic / Paracetamol overdose antidote
- 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
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.