Version July 2025
| ACLF-3 is defined as failure of 3 or more of the following organs/organ systems: | |
| Organ or organ system | Definition of failure |
| Liver | Bilirubin ≥12 mg/dL |
| Kidney | Creatinine ≥2 mg/dL and/or kidney replacement therapy |
| Brain | Grade 3 or 4 hepatic encephalopathy*, or requiring mechanical ventilation due to hepatic encephalopathy |
| Coagulation | INR ≥2.5 |
| Circulatory | Use of vasopressors to maintain blood pressure |
| Respiratory | PaO2/FiO2 ≤200, SpO2/FiO2 ≤214, or requiring mechanical ventilation due to respiratory failure |
ACLF-3: acute-on-chronic liver failure grade 3; INR: international normalized ratio.
* West Haven criteria.
