“… 1 , 2 In early asymptomatic stages, ACLD is considered compensated. With the development of portal hypertension (PH)-related complications, including ascites, hepatic encephalopathy (HE), and variceal bleeding, patients progress to decompensated ACLD (dACLD), [3] , [4] , [5] which is associated with a considerably worse prognosis. 6 , 7 Acute-on-chronic liver failure (ACLF), defined by hepatic and/or extrahepatic organ failure(s), 8 , 9 may occur in patients with dACLD 6 , 10 and is closely associated with systemic inflammation.…”