Examples of available definitions of organ failures used in patients with cirrhosis
| Failing organ | Asian Pacific Association for the Study of the Liver organ failures definition (4, 5) | European Association for the Study of Liver-Chronic Liver failure organ failures definition (9) | North American Consortium for Study of End-stage Liver Disease organ failures definition (7) |
|---|---|---|---|
| Liver | Total bilirubin ≥5 mg/dL and INR ≥1.5 | Bilirubin level of >12 mg/dL | – |
| Kidney | Acute Kidney Injury Network criteria | Creatinine level of ≥2.0 mg/dL or renal replacement | Need for dialysis or other forms of renal replacement therapy |
| Brain | West-Haven hepatic encephalopathy grade 3–4 | West-Haven hepatic encephalopathy grade 3–4 | West-Haven hepatic encephalopathy grade 3–4 |
| Coagulation | INR ≥1.5 | INR ≥2.5 | – |
| Circulation | – | Use of vasopressor (terlipressin and/or catecholamines) | Presence of shock defined by mean arterial pressure <60 mm Hg or a reduction of 40 mm Hg in systolic blood pressure from baseline, despite adequate fluid resuscitation and cardiac output |
| Respiration | PaO2/FiO2 of ≤200 or SpO2/FiO2 of ≤214 or need for mechanical ventilation | Need for mechanical ventilation |
FiO2, fraction of inspired oxygen; INR, international normalised ratio; PaO2, partial pressure of arterial oxygen; SpO2, pulse oximetric saturation.