ISGLS Post-Hepatectomy Liver Failure Grade
ISGLS grading of post-hepatectomy liver failure (PHLF).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Increased INR (or FFP need) AND hyperbilirubinemia on/after POD 5…
- Yes
- Deviation managed without invasive treatment
- Yes
Result: Grade B.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Gate
- PHLF requires increased INR (or FFP need) and hyperbilirubinemia, both above local limits, on/after POD 5 (rising if abnormal preop); otherwise no PHLF.
- Grade
- Grade C = requires invasive treatment; Grade B = deviation managed without invasive treatment; Grade A = abnormal labs, no management change.
What you enter
- Increased INR (or FFP need) AND hyperbilirubinemia on/after POD 5 (rising if abnormal preop) — the PHLF gate
- Requires invasive treatment: hemodialysis/RRT, mechanical ventilation, vasopressors, rescue hepatectomy or salvage transplant (Grade C)
- Deviation managed without invasive treatment: FFP, albumin, diuretics, non-invasive ventilation, or ICU admission alone (Grade B)
How this is calculated
Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149(5):713-724. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.