Acute on chronic liver failure (ACLF) is a distinct syndrome in patients with chronic liver
disease with rapid clinical deterioration and has high short term mortality within one
month.Despite aggressive clinical care, only half of the patients could survive an episode of
ACLF. The investigators hypothesized that the early treatment with therapeutic plasma
exchange with plasma and albumin in ACLF patients might improve overall survival in carefully
selected patients by removing cytokines, chemokines and toxic substances.