Safety and Efficacy of Mesenchymal Stem Cell Transplantation for Acute-on-Chronic Liver Failure

Inclusion Criteria: 1. Informed consent 2. Meeting the definition of ACLF: patients with previously diagnosed or undiagnosed chronic liver disease acute decompensated within 4 weeks; significant GI symptom as such fatigue, jaundice; serum total bilirubin \[TBil\] ≥10 X the upper limit of normal; coagulopathy (international normalized ratio \[INR\] ≥1.5 or prothrombin activity \[PTA\] \<40%); complicated within 4 weeks by ascites and/or encephalopathy as determined by physical examination. 3. Model for End-Stage Liver Disease (MELD) scores ranging 17-30, (MELD(i) = 0.957 × ln(Cr) + 0.378 × ln(bilirubin) + 1.120 × ln(INR) + 0.643); 4. Chronic liver disease with definitive etiology such as viral hepatitis, alcohol liver disease, drug induced liver injury or autoimmune liver diseases 5. Body weight ≥50kg Exclusion Criteria: 1. Serious complications in the previous 2 months (e.g., gastrointestinal bleeding: hemoglobin below 90g/L, serious infection such as sepsis, ascites ultrafiltration, and/or dialysis); 2. Malignant jaundice induced by obstructive jaundice or hemolytic jaundice; 3. Hepatocellular carcinoma (HCC) diagnosed by radiologic imaging and/or alpha fetoprotein (AFP); 4. Tumor diagnosed by ultrasound, CT, MR examination; 5. Moderate or severe chronic heart failure (NYHA III-IV), renal replacement therapy, severe chronic pulmonary disease (GOLD III-IV) 6. Extrahepatic cholestasis 7. Hepatic, portal and splenic vein thrombosis diagnosed by doppler ultrasound 8. Artificial liver support 9. Previous liver transplantation 10. Drug abuse in the past 5 years; 11. Mental disorders and/or has a family history of mental disorder. 12. HIV infection 13. Pregnant or breast-feeding females 14. Highly allergic 15. Patients can not cooperate or mobility 16. Enrolled in other clinical trials with 3 months 17. Patients who can not provide prior informed consent or refusal to participate