Table 1

When referral/discussion with the LTU is required for a patient with ALF7

Paracetamol induced acute liver failureNon-paracetamol induced acute liver failure
  • Arterial pH <7.30 or HCO3 <18

  • INR >3.0 on day two or >4.0 thereafter

  • Oliguria and/or AKI

  • Altered level of consciousness

  • Hypoglycaemia

  • Elevated arterial lactate (>4 mmol/L) unresponsive to fluid resuscitation

  • pH <7.30 or HCO3 <18mmol/l

  • INR >1.8

  • Oliguria/renal failure or Na <130 mmol/L

  • Encephalopathy, hypoglycaemia or metabolic acidosis

  • Bilirubin >300 umol/L (17.6 mg/dL)

  • AKI, acute kidney injury; ALF, acute liver failure; CLF, chronic liver failure; INR, international normalised ratio; LT, liver transplantation; LTU, liver transplant unit.