Acute Liver Failure Caused by Amanita phalloides Poisoning

Table 1

Criteria for urgent liver transplantation in patients with ALF. Only Ganzert’s criteria are developed specifically for Amanita phalloide poisoning.

Clichy’s criteria	(a) Combination of a decrease in factor V below 30% of normal in patients over 30 years or below 20% of normal in patients below 30 years
	(b) Grade 3-4 en cephalopathy
King’s College criteria for nonparacetamol causes	(a) Prothrombin time over 100 s (≈INR over 7) or
	(b) At least three of the following criteria:
	(i) prothrombin time over 50 sec (INR over 3.5),
	(ii) serum bilirubin over 300 μmol/L,
	(iii) age below 10 years or over 40 years,
	(iv) an interval between jaundice and encephalopathy over 7 days,
	(v) drug toxicity
King’s College criteria for paracetamol causes	(a) Arterial pH below 7.3 or arterial lactate above 3 mmol/L after adequate fluid resuscitation
	or
	(b) Concurrently, serum creatinine above 300 μmol/L, INR above 6.5 and encephalopathy of grade 3 or more
Ganzert’s criteria	(a) A decrease in prothrombin index below or equal to 25% of normal at any time between day 3 and day  10 after ingestion
	in association with
	(b) Serum creatinine over or equal to 106 μmol/L within the same time period
Escudie’s criteria	Prothrombin index below 10% of normal (INR of ≈6) 4 days or more after ingestion