Extracorporeal liver assist device to exchange albumin and remove endotoxin in acute liver failure: Results of a pivotal pre-clinical study

• DOI: 10.1016/j.jhep.2015.04.020
• Publication Date: 2015-05-02T19:20:37Z
• Authors: Karla C.L. Lee; Luisa A. Baker; Giacomo Stanzani; Hatim Alibhai; Yu Mei Chang; Carolina Jimenez ...; Pamela J. Leckie; Paola Giordano; Simon L. Priestnall; Daniel J. Antoine; Rosalind E. Jenkins; Christopher E. Go...; B. Kevin Park; Fausto Andreola; Banwari Agarwal; Rajeshwar P. Mook...; Nathan A. Davies; Rajiv Jalan
• Keywords: Extracorporeal; Bioartificial liver device

Graphical abstractAbstractBackground & AimsIn acute liver failure, severity of injury and clinical progression disease are in part consequent upon activation the innate immune system. Endotoxaemia contributes to system detoxifying function albumin, critical recovery from injury, is irreversibly destroyed failure. University College London-Liver Dialysis Device a novel artificial extracorporeal assist device, which used with albumin infusion, achieve removal replacement dysfunctional reduction endotoxaemia. We aimed test effect this device on survival pig model acetaminophen-induced failure.MethodsPigs were randomised three groups: Acetaminophen plus (n=9); Control (n=7); (n=4). treatment was initiated two h after onset irreversible failure.ResultsThe Liver resulted 67% reduced risk death failure compared (hazard ratio=0.33, p=0.0439). This associated 27% decrease circulating oxidised human non-mercaptalbumin-2 throughout (p=0.046); 54% overall endotoxaemia (p=0.024); delay development vasoplegia lung injury; systemic TLR4 signalling pathway. Device-associated adverse effects not seen.ConclusionsThe benefit lack would support trials patients.