Effect of Single vs Repeated Cycles of a Combination of Granulocyte Colony Stimulating Factor and Darbepoetin vs Standard Medical Treatment on Immunometabolic Profile in Patient With Early Decompensated Cirrhosis.

Exclusion Criteria

• •1. Patients with age less than 18 years or more than 65 years
• •2. Lack of informed consent
• •3. Patients with a history of serious allergic reactions to the active component, filgrastim, other human granulocyte colony-stimulating factors, or any of the ingredients
• •4. Evidence of alcoholic hepatitis/active alcohol abuse last intake ≤ 3 months
• •5. Suspected autoimmune hepatitis (ANA/ASMA-positive in titers 1:80 and/ or IgG 1.5 times upper limit of normal),
• •6. Hemolytic anaemia -Sickle cell disease or thalassemia
• •7. Patients with Grade III ascites /complicated ascites
• •8. Patients with large spleen (size ≥ 15cm)
• •9. Recent variceal bleeding in less than 42 days
• •10. Patients with any focus of sepsis as proven by culture positivity or presence of spontaneous Bacterial Peritonitis (SBP)
• •11. H/o Seizures
• •12. Hepatocellular Carcinoma (HCC) or other malignancy
• •13. Acute Kidney Injury (AKI) with serum Creatinine \>1.5 mg/ dl,
• •14. Multi-organ failure,
• •15. Hepatic Encephalopathy or prior history of HE in less than 6months
• •16. HIV seropositivity,
• •17. Uncontrolled essential hypertension, CAD /Stroke
• •18. Massive hydrothorax
• •19. Pregnancy
• •20. Viral etiology of liver disease
• •21. Chronic kidney disease
• •22. Portal vein thrombosis
• •23. Planned for LT
• •24. Bone marrow hematopoietic stem cells \< 0.4