NHS Trials Dialive: A Breakthrough Life-Saving Treatment for Acute-on-Chronic Liver Failure
The NHS is ready to trial a new life-saving treatment for a deadly liver disease that causes the body’s essential organs to fail. There is a device that cleans patients’ blood that has been polluted by toxins, which can develop into acute-on-chronic liver failure (ACLF). Thirteen major hospitals will use these devices.
Acute-on-chronic liver failure is a severe form of liver disease. It is hard to treat and linked to obesity, alcohol, and hepatitis, in which the patient’s condition worsens, and they have to be admitted to intensive care. Three out of four people who are affected by chronic liver disease are only diagnosed when it has become life-threatening.
If you see the statistics, seven out of ten patients die within 28 days, and only a few of them are eligible for a liver transplant. Liver transplantation is the only existing way to reverse ACLF.
This trial will consist of 72 ill patients participating in a randomised trial of a machine called Dialive. This will start early next year. Doctors who are involved in this say that it gives new hope and could also reduce the high death rate.
And if it proves successful, it could become the first form of liver dialysis in a global machine. Dialive aims to aid recovery by removing dysfunctional albumin (a protein produced by the liver) and replacing it with clean and functional albumin.
The “intensive care liver support system” works similarly to haemodialysis (a treatment for people whose kidneys have stopped working properly).
Patients are connected to the Dialive device while it removes harmful substances from their blood. This helps their liver and other organs to recover and increases their chances of survival. Patients who are already suffering from two or more organ failures will be participating in the trial. They will have sessions of treatment on their first, second, and third days and then up to four more within the first 10 days.
Rajiv Jalan, a senior liver specialist and co-principal investigator of the trial, who founded Yaqrit, said, “Our goal is to demonstrate that we can resolve life-threatening ACLF more often and faster than standard care, and thereby impact both patients’ time in hospital and chances of survival”. “These are gravely ill patients with multi-organ failure and high risk of death, so there is a desperate need for effective treatments not only here but all around the world.”
Yaqrit is a UCL spinout company that specialises in developing new drugs and devices to treat severe liver disease, which is rising worldwide as a result of soaring obesity, heavy drinking, and hepatitis infection.
The government-funded National Institute for Health and Care Research (NIHR) is funding the £2.2m trial after a previous, smaller-scale 2023 study into its safety and effectiveness found that Dialive showed promise in treating ACLF.
Ten of the 15 patients who had the treatment saw their ACLF reversed compared with just five of the 15 who had only standard treatment. Dialive patients also recovered faster than the others.
Dr Rohit Saha, a consultant at the Royal Free hospital in London and another trial co-principal investigator, said: “Many patients with ACLF die because their bodies become trapped in a destructive cycle of inflammation that current treatments can’t reverse. 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.”
“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 stays. This is taxpayer-funded research at its best, making treatments on the NHS available when they are needed.”
