Should the China-CLIF framework influence model for end-stage liver disease-based transplant priority in acute-on-chronic liver failure?

We read with interest the multicohort study by Luo et al evaluating the China-CLIF framework for acute-on-chronic liver failure (ACLF) across diverse aetiologies.1 The authors demonstrate that China-CLIF criteria and COSSH-ACLF II score improve short-term mortality prediction compared with traditional models. These findings naturally raise an important policy question: should China-CLIF-based classifications influence model for end-stage liver disease (MELD)-driven liver transplant priority?