This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/HEP.31566 This article is protected by copyright. All rights reserved DR. VINAY SUNDARAM (Orcid ID : 0000-0002-1450-7756) DR. ASHWANI SINGAL (Orcid ID : 0000-0003-1207-3998) DR. ARPAN PATEL (Orcid ID : 0000-0002-6548-4531) DR. ROBERT JOHN WONG (Orcid ID : 0000-0002-8923-2806) Article type : Original Acute on chronic liver failure from nonalcoholic fatty liver disease: a growing and aging cohort with rising mortality Short Title: NAFLD, aging, and transplant likelihood for ACLF *Vinay Sundaram, MD MSc 1 Vinay.Sundaram@cshs.org *Rajiv Jalan, MD PhD 2 R.Jalan@ucl.ac.uk Parth Shah, MD 1 Parth.Shah@cshs.org Ashwani K. Singal, MD 3 Ashwanisingal@gmail.com Arpan A Patel, MD, PhD 4 ArpanPatel@mednet.ucla.edu Tiffany Wu, MD 1 Tiffany.Wu@cshs.org Mazen Noureddin, MD 1 Mazen.Noureddin@cshs.org ^Nadim Mahmud, MD, MS, MPH, MSCE 5 Nadim.Mahmud@uhps.upenn.edu ^Robert J. Wong, MD MS 6, 7 Robertwong123@gmail.com (1) Karsh Division of Gastroenterology and Hepatology and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA (2) Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, London, UK (3) University of South Dakota Sanford School of Medicine and Avera Transplant Institute, Sioux Falls SD (4) Veterans Administration (VA) Greater Healthy System of Los Angeles and Division of Digestive Diseases, UCLA David Geffen School of Medicine, Los Angeles, CA Accepted Article