 3. ACLF, as defined by the Asian Pacific Association for the Study of the Liver Working Party, is an acute hepatic insult manifested as jaundice serum bilirubin 5 mgdL and coagulopathyinternational normalized ratio INR 1.5 or prothrombin activity 40, with complications of ascites andor encephalopathy within 4 wk in patients previously diagnosed or undiagnosed with chronic HBV associated liver disease and alcoholic liver 