Are King’s College and Clichy-Villejuif criteria used for liver transplantation still appropriate? A retrospective study over a 25-year period
Authors' conclusion
In our cohort, only one-third of ALI patients fulfilling emergency LT criteria underwent transplantation.
Study context
- Population
- Adult intensive care unit (ICU) patients with acute liver injury (ALI) fulfilling King's College Hospital (KCH) and/or Clichy-Villejuif (CV) criteria without contraindications for liver transplantation (LT), 2000–2025of 396 with ALI
- Participants
- 118 patients
- Exposure
- Transplanted vs Not transplanted
- Transplantedn = 40
- Outcome
- Incidence of LT
Methodological detailsprospectively collected data, single-centre tertiary ICU with active LT program, consecutive patients
- Prospectively collected data
- Single-centre tertiary ICU with active LT program
- Consecutive patients
Main finding
As reported in the abstract
Incidence of LT (40 out of 118)
34%
Observational data: associations, not effects.
Secondary outcomes
ICU survival
One-year survival
ICU survival
- Did not significantly differ between transplanted and not transplanted patients
One-year survival
- Did not significantly differ between transplanted and not transplanted patients
Liver dysfunction severity
- Transplanted patients had more severe liver dysfunction, with higher MELD scores driven by higher bilirubin and INR
ALI aetiology, transplanted vs not transplanted
- Auto-immune hepatitis more likely in transplanted patients (23% vs. 1%)
- P < 0.01
- Acetaminophen-induced ALI less likely in transplanted patients (25% vs. 46%)
- P = 0.03
- Ischaemic ALI less likely in transplanted patients (2% vs. 26%)
- P < 0.01
Encephalopathy progression
- More frequent in transplanted patients
Delay between ICU admission and LT (temporal trend)
- Significantly increased over the study period
Transplant-free survival among not transplanted patients · one year
- Exceeded 80% overall and remained high across all KCH/CV fulfilment patterns
- >80%
Original publication
Are King’s College and Clichy-Villejuif criteria used for liver transplantation still appropriate? A retrospective study over a 25-year period. Ann Intensive Care. Published 21 April 2026. doi:10.
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