Efficacy and Safety of G-CSF in Patients With Severe Alcoholic Hepatitis With Null or Partial Response to Steroid

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 …