Poor-prognosis criteria in non-paracetamol acute liver failure - indication for transplant referral.
The King's College Criteria — Non-Paracetamol ALF is a GI & Liver scoring tool used in paediatric practice. Poor-prognosis criteria in non-paracetamol acute liver failure - indication for transplant referral. It scores 6 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.
6. They are INR > 6.5 (prothrombin time > 100 s), regardless of encephalopathy grade; Age < 10 or > 40 years; Aetiology: non-A non-B hepatitis, halothane, or idiosyncratic drug reaction; Jaundice to encephalopathy interval > 7 days; INR > 3.5 (prothrombin time > 50 s); Serum bilirubin > 17.5 mg/dL (300 µmol/L).
The total is interpreted as: any score - Criteria not met: criteria not met on current values. Continue intensive supportive care and reassess frequently; 3 criteria or more - Criteria MET: any 3 of the 5 minor criteria - poor prognosis. Refer urgently to a liver transplant centre; 4 criteria or more - Criteria MET: iNR >6.5 alone meets the criteria in non-paracetamol ALF - refer urgently to a liver transplant centre.
No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.
Criteria met by EITHER INR >6.5 alone, OR any 3 of: age <10 or >40 y, unfavourable aetiology, jaundice-to-encephalopathy >7 days, INR >3.5, bilirubin >17.5 mg/dL.
Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.