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Inclusion and Exclusion Criteria for Patients

Inclusion

1. Patients with liver cirrhosis diagnosed by standard clinical criteria, imaging findings and/or histology with any underlying etiology;
2. Patients with ACLF grade 1, 2, or 3a according to EASL-CLIF criteria
3. Onset of ACLF not more than7 days (168 hours) before Baseline;
4. Presence of ascites requiring paracentesis;
5. Patients with dry body weight ≥ 40 and <140 kg;
6. Written informed consent obtained prior to the start of any study-related procedures.
7. 18 years to 79 years
8. All gender

Exclusion

1. Patients with acute or sub-acute liver failure;
2. Presence of the following organ(s) failure(s) as per the EASL definitions and/or adapted from CLIF-C Organ Failure (CLIF-C OF)/CLIF- Sequential Organ Failure
   Assessment (CLIF-SOFA) scores:
   1.Respiratory failure or mechanical ventilation;
   2. Coagulation failure (INR > 3.2 or platelet count ≤ 20 x 109/L);
   3. Severe cardiovascular failure requiring the use of high dose vasopressors;
3. ACLF grade 3b: Presence of four or more organ failures according to EASL-CLIF criteria (organ failures will be calculated based on CLIF-C OF score);
4. Presence of spontaneous or secondary bacterial peritonitis;
5. Presence of spontaneous bacterial pleural empyema;
6. Patients with medical history of spontaneous bacterial peritonitis over the past 2 weeks;
7. Presence of uncontrolled severe infection at SCR or Baseline (BL);
8. Patients with poorly controlled seizure disorder
9. Patients with history of upper gastro-intestinal
10. bleeding over the past 7 days, acute 10. bleeding or bleeding upon paracentesis at SCR or BL;
    Contraindication for paracentesis;
11. Coagulation disorders such as disseminated intravascular coagulation or hemophilia;
12. Potential or known hypersensitivity to liposomes;
13. Potential or known risk factors for allergic/anaphylactoid like reactions (e.g., mastocytosis/elevated basal tryptase) or multiple hypersensitivities;
14. Patients after organ transplantation receiving immunosuppressive medication;
15. Any severe disease considered to be potentially detrimental at the discretion of the Principal Investigator. This includes but is not limited to hepatocellular carcinoma outside Milan criteria, cholangiocarcinoma, extrahepatic cancer over the past 2 years
    or people who inject drugs
16. Need for Renal Replacement Therapy or any extracorporeal liver support device (e.g., MARS®, Prometheus®, plasmapheresis);
17. Alfapump® in place to manage ascites;
18. Pregnancy and lactation;
19. Women of child-bearing potential who are not willing to use adequate contraception;
20. Patients who participate in another clinical trial at the time of SCR or within 4 weeks prior to SCR.