Liver is a vital organ in the digestive system which functions as detoxification center, protein synthesizer , hormone production and glycogen storage. The most common cause for liver infection is hepatitis, alcohol/drug damage, cirrhosis, fatty liver and cancer. Jaundice, or yellowing of the skin and eyes, is one sign of a liver disease.
Liver has a great capacity to regenerate. When the liver fails, it would have sustained an extensive damage & unable remove toxins from the blood, causing them to accumulate in the blood and eventually the brain.
In the case of acute liver failure, patients will be admitted to the intensive care unit to receive a liver dialysis. Liver dialysis is a short-term detoxification treatment with similar principle as kidney dialysis. It is use as a bridging time until the liver can resume its normal function or a transplant. In some cases, transplantation can be avoided as the liver is able to regenerate itself.
Types of liver dialysis:
Single Pass Albumin Dialysis (SPAD)
SPAD uses the standard hemodialysis machines which passes the patient’s blood through a hollow fiber hemodiafilter membrane. The outer side of this membrane is filled with an albumin solution which flow in counter-directional and discarded after passing the filter. Albumin is the main protein of human blood plasma. It binds hormones, fatty acids, water, bilirubin and pharmaceutical drugs.
Molecular adsorbent recirculation system (MARS)/ Prometheus system
MARS and Prometheus systems are a combination of kidney and liver dialysis. MARS is marketed by GAMBRO and Prometheus by Fresenius Medical Care. Both systems have two dialysis circuits. The first circuit consists of two special filters to clean the albumin solution after it has absorbed protein-bound toxins from the patient's blood. The second circuit consists of hemodialysis filter that removes water-soluble toxins from patients’ blood using dialysis solution.
According to Arbios Systems Informational Brochure, The global acute liver failure market was expected to be worth US$ 3 billion in 2007 and US$ 15 billion for acute-on-chronic liver failure. American Liver Foundation reported chronic liver disease is the tenth leading cause of death in the United States, resulting in approximately $10 billion in annual healthcare costs. Currently more than 6,000 liver transplants are performed each year in the United States. The cost of the MARS® device and a single treatment cost is approximately AUD$ 30,000 and AUD$ 5000, respectively, according to Horizon scanning report HealthPACT Secretariat Australia.