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Indications for liver transplantation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

If the acute management of paracetamol poisoning is ineffective and fulminant hepatic necrosis ensues then liver transplantation is life-saving.

The indications for liver transplantation are:

  • acidosis (pH < 7.3), or
  • all of the following:
    • PT > 100 sec
    • creatinine > 300 mcg/l
    • grade 3 encephalopathy (or worse)

It is better to contact the local liver transplant centre earlier than this. Grossly abnormal prothrombin times should trigger referral:

  • PT > 20 sec at 24 hr
  • PT > 40 sec at 48 hr
  • if PT is between 20 and 40 sec at 48 hr then check the PT again at 72 hr; if PT is still > 20 sec then refer

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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