Chinese guidelines on the management of liver cirrhosis (abbreviated version)

Table 1 Child-Pugh score[15]

Clinical biochemical indicators	1 point	2 points	3 points
Hepatic encephalopathy, grade	None	1-2	3-4
Ascites	None	Mild	Moderate to severe
Total bilirubin, μmol/L	< 34	34-51	> 51
Albumin, g/L	> 35	28-35	< 28
Prothrombin time prolonged, sec	1-3	4-6	> 6

Child Pugh grading criteria for cirrhosis: Grade A: Child-Pugh score 5-6; Grade B: Child-Pugh score 7-9; Grade C: Child-Pugh score 10-15.

Table 2 Model for end-stage liver disease score[16]

Score, points	Significance
< 12
12-18	Included into the waiting list of liver transplantation
18-25	Require liver transplantation
25-30	Require emergent liver transplantation
> 30	Require emergent liver transplantation for rescue

Model for end-stage liver disease (MELD) score = 3.8 × loge [bilirubin (mg/dL)] + 11.2 × loge (INR) + 9.6 × loge [creatinine (mg/dL) + 6.4 × (causes of disease: Biliary or alcoholic 0, other 1). Bilirubin (mg/dL) = bilirubin (µmol/L) ÷ 17.1; Creatinine (mg/dL) = creatinine (µmol/L) ÷ 88.4.

Table 3 Laennec F1-F4 staging system, Laennec fibrosis staging scoring system in hepatic puncture tissue[20,21]

Stage	Name	Septum, thickness and amount	Criteria	Score
0	No clear fibrosis			0
1	Very mild fibrosis	+/-	No septum or very few thin septum, portal area enlarged or mild peri-sinusoid fibrosis	1
2	Mild fibrosis	+	Occasionally thin septum, portal area enlarged or mild peri-sinusoid fibrosis	2
3	Moderate fibrosis	++	A medium amount of thin septum, even incomplete cirrhosis	3
4A	Cirrhosis, mild, definite or possible	+++	Obvious septum, with circle outline or obvious nodules, thin septum mostly (one wide septum allowable)	4
4B	Moderate cirrhosis	++++	At least two wide septum, but no very wide septum; less than 1/2 of puncture tissues in length are composed of nodules	5
4C	Severe cirrhosis	+++++	At least one very wide septum, or more than 1/2 of puncture tissues in length are composed of nodules (micronodular cirrhosis)	6