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The King's College Criteria (KCC) identify patients with acute liver failure (ALF) who have a high risk of death without liver transplantation. Separate criteria exist for acetaminophen (APAP)-induced ALF and non-acetaminophen ALF. Meeting any single KCC criterion is a widely accepted threshold for urgent liver transplant listing evaluation. The KCC were derived from the King's College Hospital cohort (O'Grady et al., 1989) and have been externally validated worldwide.
APAP ALF — Arterial pH < 7.30 After Resuscitation
APAP ALF — All Three: PT > 100s (INR > 6.5) + Creatinine > 3.4 mg/dL + Grade 3–4 Encephalopathy
Non-APAP ALF — PT > 100s (INR > 6.5) Alone
Non-APAP ALF — Any 3 of 5 Minor Criteria Met
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