To Study the Influence of GCSF on Natural History of Acute On Chronic Liver Failure After the Acute Phase

To Study the Influence of GCSF on Natural History of Acute On Chronic Liver Failure After the Acute Phase - A Randomized Controlled Study

All consecutive ACLF (Acute on Chronic Liver failure) patients presenting to the institute of liver and biliary sciences, irrespective of the etiology , who have survived the acute phase (i.e. 90 days of onset of the acute on chronic liver failure) and who are willing to participate in the study would be enrolled. After performing baseline biochemical tests, patients will undergo transjugular liver biopsy (TJLB), HVPG (Hepatic Venous Pressure Gradient), Circulating CD34 cells, Bone marrow aspiration and biopsy (Histopathological and immunohistochemical examination will be done).

Inclusion Criteria:

• Subjects aged 18-65 years
• All patients who were known to have ACLF and have survived 3 months of the onset of acute event
• Patients willing to participate in the study

Exclusion Criteria:

• Presence of AKI (Acute Kidney Injury)
• Active sepsis (Blood/ urine culture positive, SBP (Spontaneous bacterial Peritonitis, LRTI (lower Respiratory Tract infection)
• Sickle cell anemia
• HepatoCellular Carcinoma
• Hematological malignancies
• Multi organ failure
• Grade 3/ 4 HE (Hepatic Encephalopathy)
• HIV seropositivity
• Pregnancy
• Patients being taken up for transplant
• Refusal to participate in the study