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Graphical representation of the trial; Image Courtesy Authors & Journal of Hepatology

UCL researchers complete first successful liver dialysis trial

In what could be a boon for over three million people suffering from acute-on-chronic liver failure (ACLF), researchers from University College London (UCL) said that they have completed the first successful in-patient trial of liver dialysis

When compared to patients receiving standard of care, the device developed by researchers at Institute for Liver and Digestive Health in UCL was found to be safe and associated with a significant improvement in the severity of symptoms and organ function in a greater proportion of patients with ACLF.

The findings of the trial published in the Journal of Hepatology recently found that while the treatment using the device reduced inflammation and improved clinical parameters,  it did not reduce mortality in this small study and further larger clinical trials are required to re-confirm its safety and to evaluate efficacy.

According to the researchers, the next phase, a larger clinical trial, if successful, could see the device, DIALIVE, getting a licence for clinical usage within the next three years.

It is believed that over 100 million people worldwide have cirrhosis of the liver, with 10 million having cirrhosis with an additional problem. Around three million people have ACLF, a disorder that causes liver function to quickly deteriorate, putting people at high risk of dying in the short term.

Every year, around 15,000 ACLF patients are treated in the UK, with therapy costing the NHS in the range of £100,000 per patient without reducing their mortality risk.

This is the first randomised, controlled clinical trial in humans of a liver dialysis device, whose purpose was to determine the safety of the device for treating ACLF patients and to observe its clinical effects. According to researchers, during the trial, 32 patients were treated for up to five days with DIALIVE or standard care, with results reported on days 10 and 28.

Dr Banwari Agarwal, Chief Investigator of the DIALIVE trial from the Royal Free Hospital and Honorary Associate Professor at the UCL Division of Medicine, said, “It gives me enormous pleasure to see the promise of this novel liver dialysis device for the treatment of acute-on-chronic liver failure.”

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Pointing out that the treatment option has the potential to transform the therapeutic options available to clinicians across the world for patients with ACLF, he added, “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.”

Professor Rajiv Jalan of UCL Institute for Liver and Digestive Health, part of the UCL Division of Medicine, and the inventor of DIALIVE said, “As academics, it can be difficult to define a disease and then translate this knowledge into a clinical solution that makes a real difference to people’s lives.”

Pointing out that within a few years, the team will start to fulfil the urgent unmet need for treating acute-on-chronic liver failure and improve outcomes for patients, he added, “So the results of the DIALIVE trial are an emotional moment, which would not have been possible without scientific collaboration between the UK, European colleagues and funding from the European Commission.”

It may be noted that dialysis is a technique for cleaning the blood of harmful substances that is more commonly used in treating patients with impaired or absent renal function, who must undergo therapy for several hours each day. However, because of the regenerating abilities of the liver, researchers predict that liver dialysis would be able to deliver longer-term advantages after a brief treatment period.


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