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The NHS is set to trial a new blood-cleansing device that could transform treatment for acute-on-chronic liver failure (ACLF), a sudden and often fatal deterioration seen in people with underlying liver disease linked to obesity, alcohol use, or hepatitis. ACLF is notoriously difficult to treat: around 70% of patients die within 28 days, and many are diagnosed only once the condition has become life-threatening. For most patients, a liver transplant is currently the only effective option, yet only a small minority are eligible.
The trial will test a machine called Dialive in 72 critically ill patients across 13 major NHS hospitals, beginning early next year. Dialive works like a form of “liver dialysis,” filtering toxins from the blood when the liver can no longer do so. Crucially, it removes damaged albumin—a key protein made by the liver—and replaces it with healthy, functional albumin, helping to reduce inflammation and give the liver and other organs a chance to recover. Patients will receive several treatment sessions over the first 10 days of intensive care.
The study is being led by Professor Rajiv Jalan, a hepatologist at University College London (UCL) and co-principal investigator, alongside colleagues including Dr Rohit Saha and Dr Mansoor Bangash. Dialive was developed by Yaqrit, a UCL spin-out company. A smaller safety and effectiveness study in 2023 showed promising results, with 10 out of 15 Dialive-treated patients seeing their ACLF reversed, compared with five out of 15 receiving standard care alone, and faster recovery overall.
Funded by £2.2 million from the National Institute for Health and Care Research (NIHR), the new randomised controlled trial aims to show whether Dialive can improve survival, shorten hospital stays, and potentially reduce the need for liver transplants. If successful, it could become the first liver dialysis system used in routine clinical care, offering new hope for thousands of severely ill patients each year. No journal publication has yet been associated with this trial.
