Figgorilli et al reported the Acute Liver Failure-Organ Failure (ALF-OF) score in a patient with acute liver failure. This can help to identify a patient who is at high risk for a futile liver transplant. The authors are from UCL Medical School, Royal Free Hospital, Hospital Beaujon, and University Paris Diderot.
Futile liver transplant: death within 48 hours of transplant surgery AND multiple organ failures and/or irreversible brain damage AND without major surgical complications (hepatic artery thrombosis, portal vein thrombosis, outflow obstruction, hemorrhage, shock) AND NOT graft non-function.
Parameters:
(1) CLIF-C organ failure (OF) score, from 0 to 18
(2) norepinephrine dose in micrograms per minute
acute liver failure-organ failure score =
= (0.391 * (CLIF-C OF score)) + (0.020 * (norepinephrine dose))
Interpretation:
• A score > 5.58 for liver transplant.
• A score > 6.5 identifies futile liver transplantation.
Performance:
• The area under the ROC curve for liver transplant is 0.90.
• The area under the ROC curve for futile liver transplant is 0.92.
