CytoSorb® in Patients With Acute on Chronic Liver Failure

Inclusion Criteria: 1. Age≥18 2. Signed Informed Consent Form (ICF) 3. Total bilirubin ≥ 8 mg/dL 4. Acute Alcoholic Hepatitis diagnosed by EtOH consumption within 6 weeks of onset of symptoms, exclusion of other causes for jaundice and liver biopsy or at least 2 out of the following symptoms: * Hepatomegaly * AST \> ALT * Elevated WBC * Ascites 5. Maddrey DF \> 32 6. Systemic inflammation as defined by 2 fulfilled criteria out of: * leucocytosis * body temperature \> 38°C * tachycardia \> 90 bpm * tachypnoeia \> 20 breaths/min 7. ACLF grade ≥2 8. Creatinine \>2 mg/dl and increase \>1.5 mg/dl despite standard of care Exclusion Criteria: 1. Platelets \< 40,000/mm3 2. INR \> 3.5 3. MELD Score \> 35 4. AST \> 500 IU/l 5. Bilirubin reduction \> 20% in prior 72 hours (early responders to conventional Standard of Care (SOC)) 6. Uncontrolled infection, bleeding or hemodynamic instability 7. Small liver size (diagnosed by imaging, ultrasound/CT) 8. Chronic dialysis 9. Contraindications for CytoSorb® according to Instructions for Use 10. ACLF grade \<2