ALIVER consortium members were present at the International Liver Congress™ (ILC) 2017, where ALIVER Project Investigator, Prof. Rajiv Jalan presented information on both artificial and biological extracorporeal liver assist devices. All extracorporeal devices were present at the ILC 2017 Skills Learning Centre. At The Skills Learning Centre, delegates were given the opportunity to ask questions and closely examine devices used for procedures under the tutelage of experts in the field. This new activity was presented in a relaxed and friendly atmosphere during which delegates talked with experts and asked an array of questions related to the practice of interventions in patients with liver disease. The devices and methods presented at The Skills Learning Centre included:
Artificial
- PLASMA EXCHANGE
- MARS
- DIALIVE
Biological
- ELAD
- SR BAL
- AMC-BAL
Rationale for extracorporeal liver support
Fig. 1 – Potential for reversibility
Prof. Jalan explained that liver failure, whether of the acute variety with no pre-existing liver disease (acute liver failure (ALF)) or an acute episode of decompensation superimposed on a chronic liver disorder (acute on chronic liver failure (ACLF)), carries a high mortality. An ideal liver support system would provide many of the normal functions of the liver, be easy to use in clinical practice, have minimal complications, and not be prohibitively expensive. During his presentation, Prof. Jalan noted that so far, the bioartificial liver systems have failed to live up to their initial promise and currently cannot be recommended for the treatment of patients outside of carefully controlled clinical trials. Jalan et al. Gut (2004). “ALIVER is an opportunity to alter the course of the disease and a chance to change the patients’ outlook on life,” Prof. Rajiv Jalan, ALIVER Project Investigator.
A great time for devices
Fig. 2 – Mortality rate at 28 days and 90 days according to the grade of ACLF
Acute on chronic liver failure (ACLF) is a syndrome in patients with chronic liver disease with or without previously diagnosed cirrhosis characterized by acute hepatic decompensation resulting in liver failure (jaundice and prolongation of the international normalized ratio), and one or more extrahepatic organ failures, that is associated with increased risk for mortality within a period of 28 days and up to 3 months from onset Jalan, et al. Gastroenterology (2014).
To learn more about the ALIVER project’s extracorporeal liver support device (DIALIVE), click HERE.
