F2 and congenital secretory chloride diarrhea 1: However, according to the Asian Pacific Association for the Study of the Liver, ACLF is an acute hepatic insult manifesting as jaundice (serum bilirubin ≥5 mg/dL) and coagulopathy (international normalized ratio [INR] ≥1.5 or prothrombin activity <40%) complicated within 4 weeks by clinical ascites and/or encephalopathy in a patient with previously diagnosed or undiagnosed chronic liver disease (CLD)/cirrhosis (6,7).