ALB and immune system disorder: Knowledge about the pathophysiologic mechanisms of AD/ACLF caused by hepatic damage, portal hypertension, systemic inflammation, immunodeficiency, and gut symbiosis has also helped predict prognosis and identify related factors such as the CLIF-C ACLF-D score, which is a tool to predict the development of ACLF with higher accuracy than MELD and CPS and is composed of age, ascites, WBC count, albumin, bilirubin, and creatinine levels [5,8].