Hepatic Activity Index
Liver Transplantation

HISTOLOGY ACTIVITY INDEX (HAI - Knodell Score)
Periportal ± Bridging Necrosis Score Intralobular Degeneration and Focal Necrosis Score Portal Inflammation Score Fibrosis Score
None 0 None 0 No portal inflammation 0 No fibrosis 0
Mild piecemeal necrosis 1 Mild (acidophilic bodies, ballooning degeneration and/or scattered foci of hepatocellular necrosis in 1/3 of lobules or nodules) 1 Mild (sprinkling of inflammatory cells in <1/3 of portal tracts) 1 Fibrous portal expansion 1
Moderate piecemeal necrosis (involves <50% of the circumference of most portal tracts) 3 Moderate (involvement of 1/3-2/3 of lobules or nodules) 3 Moderate (increased inflammatory cells in 1/3-2/3 of portal tracts) 3 Bridging Fibrosis (portal-portal or portal-central linkage) 3
Marked piecemeal necrosis (involves >50% of the circumference of most portal tracts) 4 Marked (involvement of >2/3 of lobules or nodules) 4 Marked (dense packing of inflammatory cells in >2/3 of portal tracts) 4 Cirrhosis 4
Moderate piecemeal necrosis plus bridging necrosis 5 Reference

Knodell RG, et al. Formulation and Application of a Numerical Scoring System for Assessing Histological Activity in Asymptomatic Chronic Active Hepatitis. Hepatology 1981;1(5):431-5

Marked piecemeal necrosis plus bridging necrosis 6
Multilobular necrosis 10
Total HAI (Knodell Score) = __/22


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Last Modified: Thu Jun 18 10:14:08 EDT 2009