Inclusion Criteria:  Hospitalized patients Age >18 years Chronic liver disease regardless of the etiology Total bilirubin ≥ 12mg/dl and INR ≥ 1.5  Exclusion Criteria:  Three or more organ failure (SOFA criteria) Pregnant With serve chronic non-liver organ failure HIV infection without treatment Unstable hemodynamics caused by acute bleeding Proven infection with fever (>37.5°C) or hemodynamically-instable The diagnosis of hepatocellular carcinoma during screening period Hospital stays <48 hours Patients unwilling to treat with DPMAS alone or in combination with plasma exchange (suitable for the DPMAS treatment group) Patients with DPMAS treatment or other artificial liver support system (suitable for Standard medical therapy group) Not sign the informed consent Not suitable to participate in this study judging by the researchers