Study About Hepatic Toxins Kinetic and Evaluation of Organ Damage in Acute on Chronic Liver Failure (ACLF) Patients

This study examines how toxins build up in the blood during acute-on-chronic liver failure (ACLF) — a sudden severe worsening of chronic liver disease — and whether a blood-purification device called CytoSorb can remove these toxins and reduce organ damage. **You may be eligible if...** - You are 18 or older - You have been diagnosed with acute decompensation of chronic liver disease with at least grade 2 ACLF (meaning at least two organs are failing) - You are receiving or are planned to receive CytoSorb blood-purification treatment - You are able to give informed consent **You may NOT be eligible if...** - You are under 18 - You have sudden (fulminant) liver failure without underlying chronic disease - You have end-stage liver disease with chronic complications like ongoing confusion (encephalopathy) or persistent fluid buildup (refractory ascites) - You have serious pre-existing heart failure or had a recent heart attack - You are immunosuppressed due to a rheumatological or autoimmune condition Talk to your doctor to see if this trial is right for you.