NHS to Trial Revolutionary ‘Liver Dialysis’ for Deadly Disease
The NHS is set to trial a new treatment that coudl save the lives of patients suffering from acute-on-chronic liver failure (ACLF), a devastating condition causing vital organ failure. Thirteen major hospitals will participate in the trial, utilizing a device to cleanse the blood of toxins in patients with ACLF.
ACLF is a severe and challenging form of liver disease often linked to obesity, alcohol consumption, and hepatitis. It causes a sudden deterioration in patients, frequently requiring intensive care.Tragically, three out of four individuals are diagnosed only when the condition becomes life-threatening.
Currently, seven out of ten people with ACLF die within 28 days, and liver transplant remains the only potential cure, available to only a small number of patients.
The randomised controlled trial, commencing early next year, will involve 72 seriously ill patients and focus on a machine called Dialive. Doctors believe this technology “offers new hope” and has the potential to significantly reduce the disease’s high mortality rate.
If accomplished, Dialive could become the first form of liver dialysis in the world. The system works by removing dysfunctional albumin – a protein produced by the liver – and replacing it with a clean, functional version, aiding the liver’s recovery.
The “intensive care liver support system” functions similarly to haemodialysis,a well-established treatment for kidney failure,removing harmful substances from the blood to allow organs to recover and improve survival chances.
Patients participating in the trial,already experiencing two or more organ failures,will receive treatment sessions on their first three days,with the possibility of up to four additional sessions within the first ten days.
New Trial Offers Hope for patients with Acute-on-Chronic liver failure
A new clinical trial, funded by a £2.2 million grant from the national Institute for Health and Care Research (NIHR), is underway to assess the effectiveness of a novel device called Dialive in treating acute-on-chronic liver failure (ACLF). ACLF is a severe condition that affects the liver and kills more than 12,000 people a year in the UK.
The trial follows a promising smaller-scale study published in 2023 in the Journal of Hepatology (https://www.journal-of-hepatology.eu/action/showPdf?pii=S0168-8278%2823%2900188-5). That study indicated Dialive could potentially reverse the condition and accelerate recovery. In the initial study, ten out of fifteen patients treated with Dialive experienced ACLF reversal, compared to only five out of fifteen receiving standard treatment.
“Many [patients with ACLF] die as their bodies become trapped in a destructive cycle of inflammation that current treatments can’t reverse,” explained dr. Rohit Saha, a consultant at the Royal Free Hospital in London and a trial co-principal investigator. “dialive… offers new hope, with the potential to put this condition into remission and, for the first time in decades, give us a new path forward for our sickest liver patients.”
ACLF presents three primary outcomes for patients: liver transplant, recovery, or death. the trial aims to increase the number of patients who can achieve recovery without needing a transplant.
The first three hospitals recruiting patients for the trial are King’s College Hospital, University College London Hospital, and the Queen Elizabeth Hospital Birmingham, with a total of 13 teaching hospitals participating.
Dr.Mansoor Bangash, a consultant at the Queen Elizabeth Hospital and fellow principal investigator, emphasized the potential impact: “If we can support more patients to recover, with new devices like Dialive, while simultaneously tackling underlying infections, then we can improve survival rates, stabilise their health and ensure thay are in the best possible condition for a transplant-free future.”
The NIHR is funding the trial with the hope that Dialive could reduce the need for liver transplants, which are limited by organ availability. Prof. Mike Lewis,the NIHR’s scientific director for innovation,stated,”Acute-on-chronic liver failure is a perilous – and often deadly – condition. The only available treatment for it is a transplant,which isn’t always possible or an organ available. If this NIHR-funded trial of Dialive is successful, it will bring dramatic benefits for patients, providing a treatment for ACLF that will save lives and reduce hospital stay. This is taxpayer-funded research at its best, making treatments on the NHS available when they are needed.”