Liver failure

Liver failure refers to a pathological condition characterized by the deterioration of liver function. Due to the liver’s inability to perform its normal detoxification function, various molecules and metabolites accumulate systemically.

This leads to toxicity and disturbances in different enzymatic processes, which can result in complex clinical pictures such as severe coagulopathy, cerebral edema, hepatic encephalopathy, metabolic and circulatory disturbances, acute renal failure, often associated with a systemic inflammatory response (SIRS) resulting in multi-organ dysfunction.

Among the molecules and metabolites involved are bilirubin, bile acids, and ammonia, whose accumulation causes toxicity, especially at the cerebral level, in addition to a massive cytokine cascade.

Liver failure can deteriorate to the extent that the only definitive long-term treatment may be orthotopic liver transplantation.

In recent years, extracorporeal blood purification therapies have been introduced with the aim of temporarily supporting liver function, focusing particularly on the purification and adsorption of molecules involved in the degenerative process. The use of liver support systems can be beneficial both as a bridge to transplantation (‘bridge to transplant’) and to temporarily support liver detoxification until its functional recovery.

Among these methods are conventional dialysis techniques. However, these techniques, which are focused on removing low molecular weight water-soluble compounds, have difficulty in effectively removing protein-bound molecules such as bilirubin and bile acids, which are critical in liver failure.

Currently, there are extracorporeal treatments capable of dual-action adsorption: targeting both inflammatory mediators typical of these patients and metabolites involved in liver failure, such as bilirubin.

Molecules to remove: Bilirubin, Bile Acids, Ammonia, Cytokines
Recommended Therapies: CytoSorb^®

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