Clinical Research Directory

Inclusion Criteria: Patients with acute liver failure defined as patients with jaundice which is complicated by encephalopathy and coagulopathy within 4 weeks of the onset of jaundice and without underlying chronic liver disease. Cerebral edema documented on CT-scan and arterial ammonia \>150 ug/dL Exclusion Criteria: 1. Age \<18 or \> 70 years 2. HCC 3. Active untreated Sepsis/DIC 4. Hemodynamic instability non-responsive to initial fluid resuscitation with norepinephrine \>0.1 ug/kg/min 5. Post-resection and malignancy related liver failure 6. Coma of non-hepatic origin 7. Patients with uncontrolled infection 8. Patients with pulmonary involvement with Pa02/Fio2 ratio below 200. 9. Patients with post renal obstructive AKI, AKI suspected due to glomerulonephritis, interstitial nephritis or vasculitis based on clinical history and urine analysis 10. Extremely moribund patients with an expected life expectancy of less than 24 hours 11. Pregnancy related liver failure 12. Comorbidities associated with poor outcome (Extrahepatic neoplasia, severe cardiopulmonary disease defined by a New York Heart Association score \>3, or oxygen/steroid-dependent chronic obstructive pulmonary disease) 13. Refusal to participate in the study 14. Drug-induced ALF