Clinical Research Directory

Inclusion Criteria: * Written informed consent for participation in the study * Admission to the ICU with a diagnosis of ACLF of reversible etiology (infection, bleeding, alcohol-related, toxic, etc.) * Total bilirubin ≥ 12 mg/dL and INR ≥ 1.5 * On the waiting list for liver transplantation or not a candidate for transplantation but with an indication for supportive therapy Exclusion Criteria: * Refusal to provide consent * Pregnancy * Expected survival \< 24 hours due to disease severity (hemodynamic instability requiring norepinephrine \> 0.20 mcg/kg/min and/or mechanical ventilation with PaO₂/FiO₂ \< 150 and/or non-hepatic coma) * ACLF severity greater than CLIF-C ACLF grade 3 * Advanced organ dysfunction: Pulmonary (GOLD stage 3 or 4) and/or Cardiac (NYHA functional class III or IV) * Advanced or metastatic oncological disease (life expectancy \< 6 months) * Marked frailty syndrome or secondary sarcopenia * Participation in another clinical trial within the previous 3 months