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©The Author(s) 2025.
World J Transplant. Sep 18, 2025; 15(3): 101865
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.101865
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.101865
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 |
Table 2 Clichy criteria for selection of acute hepatic failure patients for liver transplantation[7]
Number | Criteria |
1 | Presence of hepatic encephalopathy |
2 | Factor V level of < 20% (if patient’s age < 30 years) or < 30% (if patient’s age ≥ 30 years) |
Table 3 Absolute and relative psychiatric contraindications to urgent liver transplant in the Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh[14]
Absolute contraindications | Relative contraindications |
5 or more episodes of deliberate self-harm, unless previous events occurred many years ago | 2-4 Lifetime episodes of self-harm |
Current substance dependence of active misuse in a severe, chaotic fashion | Current/recent substance misuse |
Chronic, severe, poor-prognosis mental disorders, especially if refractory to treatment or where leading to patient incapacity to express wishes or understand circumstances | Other significant or serious pervasive mental disorder |
Repeated non-compliance with medical or psychiatric care | - |
Patient refusal of transplant with capacity |
- Citation: Impey ORE, Baker JD, Smyth RS, Potts SG. Death after psychiatric contraindications to urgent liver transplant for paracetamol overdose. World J Transplant 2025; 15(3): 101865
- URL: https://www.wjgnet.com/2220-3230/full/v15/i3/101865.htm
- DOI: https://dx.doi.org/10.5500/wjt.v15.i3.101865