Death after psychiatric contraindications to urgent liver transplant for paracetamol overdose

Table 1 King’s College criteria for selection of acute hepatic failure patients suitable for liver transplantation[6]

Classifications	Characteristics
Paracetamol-induced acute hepatic failure	Arterial blood pH < 7.30 (irrespective of grade of encephalopathy)
	Or all of the following	Prothrombin time > 100 seconds (INR > 6.5)
		Serum creatinine > 300 μmol/L
		Grade III or IV hepatic encephalopathy
Non-paracetamol induced acute hepatic failure	Prothrombin time > 100 seconds (INR > 6.5) (irrespective of grade of encephalopathy)
	Or any 3 of the following (irrespective of grade of encephalopathy)	Age < 10 years or > 40 years
		Aetiology: Non-A/non-B hepatitis, drug-induced
		Duration of jaundice to encephalopathy > 7 days
		Prothrombin time > 50 (INR > 3.5)
		Serum bilirubin > 300 μmol/L

Citation: O'Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989; 97: 439-445. Copyright © 2025 Elsevier Inc. *INR: International normalized ratio.