Health & Medical, UK (Commonwealth Union) – A liver dialysis machine may become a reality soon, thanks to the positive results that have been demonstrated so far.
The 1st successful in-patient trial of liver dialysis was conducted by scientists from the University College London (UCL), the Royal Free Hospital, and UCL spin-out Yaqrit together with those who collaborated on the project.
The DIALIVE device is an invention by scientists from the UCL, Institute for Liver and Digestive Health, has demonstrated safety and was linked with notable enhancements in the severity of symptoms together with organ function in a greater proportion of patients that had an acute-on-chronic liver failure (ACLF), when contrasted to a patient getting the standard of care, as indicated in the findings appearing in The Journal of Hepatology.
Moving forward researchers hope to have a wider clinical trial, that with a positive outcome may see DIALIVE approved in clinical applications within the next 3 years.
Across the globe, there are estimations of approximately a hundred million individuals living with cirrhosis for the liver and ten million that have cirrhosis together with an additional complication. Approximately 3 million of those individuals have ACLF.
ACLF is a life-threatening condition that represents the convergence of acute liver injury with pre-existing chronic liver disease. It is characterized by rapid deterioration of liver function, leading to multi-organ dysfunction and high mortality rates. ACLF poses a significant challenge to healthcare professionals, demanding early recognition, prompt intervention, and comprehensive management. This article aims to provide an overview of ACLF, its underlying causes, clinical features, and treatment strategies.
ACLF arises from a complex interplay of inflammatory, immune, and metabolic processes that lead to liver decompensation. It occurs predominantly in individuals with pre-existing chronic liver diseases, such as chronic hepatitis B or C, alcoholic liver disease, non-alcoholic fatty liver disease, or cirrhosis. The exact triggering event that causes the acute insult in ACLF can vary, ranging from infection (bacterial, viral, or fungal) and alcohol abuse to drug-induced liver injury or surgical procedures.
The UK reports approximately 15,000 ACLF patients annually whose treatment costs the NHS in the area of £100,000 for each patient, with no improvement in their mortality risk.
The liver is a complex organ that carried out more than 500 functions, such as the elimination of harmful substances from the blood along with absorbing nutrients. A function of it is to form large quantities of a protein known as albumin, that moves around the body playing the role of a ‘mobile liver’ absorbing substances not needed. However, when liver function is seriously lowered, due to the impact of alcohol abuse, obesity, or viral infection, lower quantities of albumin are formed.
With ACLF, the role is further severely impacted, where liver cells are destroyed and the gut starts to permit bacteria into the bloodstream. This can lead to an undesired immune response as well as multiorgan failure. DIALIVE was formed to look into these mechanisms that lead to mortality in ACLF patients.
This study which is the 1st human randomized, a controlled clinical trial for a liver dialysis device, was conducted with the goal of evaluating the safety of DIALIVE for the treatment of ACLF patients and noting its clinical effects.
Dr Banwari Agarwal, who is the Chief Investigator of the DIALIVE trial from the Royal Free Hospital says “It gives me enormous pleasure to see the promise of this novel liver dialysis device for the treatment of acute-on-chronic liver failure. The intervention has the potential to transform the care provided to the ever-increasing number of patients and their families suffering from the effects of living with what is essentially a terminal illness for many. It has the potential to transform the therapeutic options available to clinicians across the world for patients with ACLF.”
