We need evidence-based futility thresholds to transplant grade-3 acute on chronic liver failure patients with poor respiratory, haemodynamic, and metabolic parameters

This is the authors' abstract. We don't add key points for this paper.

Bernal and colleagues showed that liver transplantation (LT) in grade-3 acute on chronic liver failure patients (ACLF-3) was highly efficacious under the recently implemented British prioritisation policy.1 An even greater effect was that the LT-free survival was null (survival benefit). After the pioneering articles2,3 reporting the LT-feasibility in well-selected ACLF-3, Centres started listing and prioritising them according to the Model for End-stage Liver Disease sodium score. However, national or regional prioritisation rules remain undefined4 and identification of delisting criteria when progression occurs is lacking.