Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: This will be a randomized double blind study which will be conducted on patients admitted to Department of Hepatology from June 2013 to may 2014 at ILBS, New Delhi. Patients not having any exclusion criteria will undergo bone marrow examination and liver biopsy at the baseline.

60 patients of decompensated cirrhosis will be randomised into two limbs- limb A (30 patients) will receive G-CSF and erythropoietin while those on limb B (30 patients) will receive G-CSF alone. The drugs will be given for 2 months and patient will be followed for 1 year. G-CSF will be given at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every 3rd day till day 60 (total 22 doses). Erythropoietin will be given s/c at dose of 500 IU/Kg twice a week for 2 months.

Follow up will be done on days 0,3,7,14,28, day 42 (6 weeks), day 60 (2 months), day 90 (3 months), day 180 (6 months), day 270 (9 months); and day 360 (1 year).


Options:
A: Inclusion Criteria: Patients with

* Clinical significant alcohol intake history (men over 50g within 3 months, women over 40g within 3 months)
* modified DF score greater than or equal to 32
* Transjugular liver biopsy shows typical feature of alcoholic hepatitis or meet the clinical diagnosis (total serum bilirubin level over 5 mg/dL, aspartate aminotransferase/alanine aminotransferase ratio \>2, aspartate aminotransferase \< 300 IU/L)
* Included patients should meet the all above criteria and Lille score \> 0.16 at the day 7 of prednisolone 40mg (or 32 mg of methylprednisolone) daily treatment.

Exclusion Criteria: Patients with

* hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), or anti-human immunodeficiency virus (HIV) (+)
* Malignancy including hepatocellular carcinoma
* Portal vein thrombosis, hemochromatosis, autoimmune hepatitis, Wilson's disease, alpha-1-antitrypsin deficiency
* Pregnancy, breast feeding, or who refuses contraception, or who cannot do contraception
* History of adverse event including allergic response, hypersensitivity to G-CSF
* Hypovolemic shock due to gastrointestinal hemorrhage or who need packed red blood cell (RBC) transfusion more than 3 units or increased modified discriminant factor (DF) score greater or equal to 32 from below 32 due to gastrointestinal hemorrhage
* Sepsis or uncontrolled acute infection
* Hepatic encephalopathy grade 3-4
* History of steroid or pentoxifylline treatment within 3 months
* Myeloblast on peripheral blood smear test
* Critical comorbidities (type I hepatorenal syndrome, serum creatinine \>2.5mg/dL, heart failure, pulmonary disease, psychiatric disease, acute pancreatitis etc.)
* Who refuses to participate in clinical trial
B: Inclusion Criteria:

Alcoholic hepatitis patients:

1. More than 10 years of heavy alcohol consumption (mean intake ≈ 100 g/day).
2. Elevated aspartate aminotransferase level (but \<500 IU per millilitre) and Ratio ofAST/ALT≥2 times
3. Elevated serum total bilirubin level ≥ 5 mgdL (86 μmol/L)
4. Elevated INR(≥1.5) and
5. Neutrophilia. Patient with Maddrey's DF of≥ 32 will be included in the study, with or without biopsy.

Exclusion Criteria:

1. Age \< 18 and \> 75 years
2. Hepatocellular carcinoma or portal vein thrombosis
3. Refusal to participate in the study
4. Serum creatinine \>1.0 mg%
5. Hepatic encephalopathy- grade 3 or 4
6. Upper gastrointestinal bleed in last ten days
7. Uncontrolled bacterial infection
8. Human immunodeficiency virus, Hepatitis B virus, Hepatitis C virus seropositivity, Autoimmune hepatitis, hemochromatosis, Wilson's disease, alpha1-antitrypsin deficiency
9. Pregnancy
10. Glucocorticoid treatment
11. Significant co-morbidity
12. Previous known hypersensitivity to G-CSF/NAC
C: Inclusion Criteria:

* Subjects aged 18-65 years
* All patients who are known to have cirrhosis of liver with portal hypertension and are compensated on presentation with no features of ascites/ jaundice/ bleed/ HE/ HRS.
* Only patients with alcoholic cirrhosis and cryptogenic cirrhosis (etiology work up negative) will be enrolled in the study.

Exclusion Criteria:

* Sepsis ( Any culture positive: blood, urine, any other obvious source of infection: UTI, LRTI)
* Variceal bleed in the past 3 months
* Autoimmune disorders
* HCC (Hepatocellular Carcinoma)
* Multi organ failure
* Any features of decompensation in form of ascites/Jaundice/ HE (grade 3 or 4) / HRS
* HIV seropositivity
* Essential hypertension
* Pregnancy
* Refusal to participate in the study
D: Inclusion Criteria:

1. age from 17ys to 70ys;
2. fale or femal;
3. ACLF, as deﬁned by the Asian Pacific Association for the Study of the Liver Working Party, is an acute hepatic insult manifested as jaundice (serum bilirubin ≥ 5 mg/dL) and coagulopathy\[international normalized ratio (INR) ≥ 1.5 or prothrombin activity\< 40%\], with complications of ascites and/or encephalopathy within 4 wk in patients previously diagnosed or undiagnosed with chronic HBV associated liver disease and alcoholic liver

Exclusion Criteria:

1. super-infection or co-infection with hepatitis A, C, D, E,Epstein-Barr virus, cytomegalovirus, or human immunodeficiency virus;
2. a previous course immuno-modulator or cytotoxic/immunosuppressive therapy for chronic hepatitis within the prior 12 mo;
3. hepato-cellular carcinoma diagnosed by computed tomography or magnetic resonance imaging;
4. co-existence of any other serious medical illnesses or other liver diseases such as autoimmune hepatitis, drug-induced liver injury or Wilson's disease;
5. any concurrent evidence of sepsis;
6. malignant jaundice induced by obstructive jaundice and hemolytic jaundice;
7. prolonged prothrombin time due to blood system disease.

Answer: C