National Collaborative Centre for Hepatic Regenerative Medicine (NC-CHRM): Phase I Study on Safety and Efficacy of Mesenchymal Stem-Cell (MSC) Therapy in Non-Viral Acute-on-Chronic Liver Failure (ACLF)

Inclusion Criteria: * ACLF patients with Model for End-Stage Liver Disease (MELD) \>18 or APASL ACLF Research Consortium (AARC) grade 2 or more with (no or single extrahepatic organ dysfunction or failure having no option of liver transplant). Exclusion Criteria: * Age \<18 or \>65 yrs * Patients with active sepsis * Patients with hepatic venous outflow tract obstruction (HVOTO) or Extrahepatic portal vein obstruction (EHPVO) * Hepatocellular carcinoma (beyond Milan) or any extrahepatic malignancy * Active bleed (mucosal or variceal) or severe coagulopathy (platelets \<20,000 or INR\>4) * Patients with refractory shock requiring norepinephrine \>0.5ug/kg/min * Patients with severe Acute Respiratory Distress Syndrome (ARDS) with Pa02/Fi02 \<150 * Patients with retroviral infections * Autoimmune hepatitis * Viral etiology of liver disease * Co-existent Hepatitis B, Hepatitis C, HIV * Chronic kidney disease * Multiorgan failure or disseminated intravascular coagulation (DIC) * Patients improving on standard medical treatment * Patients on immunosuppressive medications * Pregnancy or active breastfeeding * Known severe cardiopulmonary diseases (structural or valvular heart disease, coronary artery disease, coronary pulmonary disease, chronic kidney disease) * Lack of informed consent