Imagine a future where a deadly liver disease no longer spells certain doom. That future might be closer than you think. The NHS is set to trial a groundbreaking treatment that could revolutionize the way we tackle acute-on-chronic liver failure (ACLF), a condition so severe that it often leads to multiple organ failure and death. But here's where it gets even more intriguing: this treatment doesn’t involve surgery or medication—it’s a device that cleanses the blood of toxins, offering a lifeline to those on the brink of losing their battle with this relentless disease.
ACLF is a silent killer, often linked to obesity, excessive alcohol consumption, and hepatitis. What makes it particularly terrifying is its sudden onset—patients can deteriorate rapidly, landing them in intensive care. And this is the part most people miss: three out of four cases are diagnosed only when the disease has already become life-threatening. The statistics are grim: seven out of 10 people with ACLF die within 28 days, and only a handful are eligible for a liver transplant, currently the only cure. But what if we could change that?
Enter Dialive, a machine that promises to be a game-changer. Starting early next year, 72 critically ill patients across 13 major hospitals will participate in a randomized controlled trial of this device. Dialive works by removing dysfunctional albumin—a protein vital for liver function—and replacing it with clean, functional albumin. Think of it as a liver dialysis, similar to how haemodialysis supports failing kidneys. Patients are connected to the device, which filters out harmful substances from their blood, giving their liver and other organs a fighting chance to recover.
But here’s where it gets controversial: Could Dialive render liver transplants obsolete for some patients? The trial’s co-principal investigator, Rajiv Jalan, a leading liver specialist and founder of Yaqrit—the company behind Dialive—believes so. He argues that by cleaning the blood of toxins and allowing the liver to regenerate, Dialive could resolve ACLF faster and more effectively than standard care. If successful, this could not only reduce hospital stays but also save lives on a global scale.
The stakes are high, and the need is urgent. Liver disease is on the rise worldwide, fueled by soaring obesity rates, heavy drinking, and hepatitis infections. In the UK alone, an estimated 2 million people suffer from some form of liver disease, with rates quadrupling over the past 50 years. Over 12,000 people die annually from this condition, and only 60,000 are eligible for transplants. Dialive offers a glimmer of hope in this bleak landscape.
A smaller-scale study in 2023 showed promising results: 10 out of 15 patients treated with Dialive saw their ACLF reversed, compared to just 5 out of 15 on standard treatment. Patients on Dialive also recovered faster. Dr. Rohit Saha, a consultant at the Royal Free Hospital in London, calls it a “new path forward” for the sickest liver patients. But is it too good to be true? Critics might argue that the sample size is small, and long-term effects remain unknown. What do you think? Could Dialive be the breakthrough we’ve been waiting for, or is it just another experimental treatment with limited potential?
The £2.2m trial, funded by the National Institute for Health and Care Research (NIHR), aims to answer these questions. If successful, Dialive could transform the way we treat ACLF, making liver transplants a last resort rather than the only option. As Prof. Mike Lewis, NIHR’s scientific director for innovation, puts it, this is taxpayer-funded research at its best—a potential lifeline for thousands. But the real question remains: Will it work? And if it does, are we ready for the ethical and logistical challenges it might bring?
What’s your take? Do you think Dialive could revolutionize liver disease treatment, or is it too early to celebrate? Let’s spark a conversation in the comments—your perspective could be the missing piece in this life-saving puzzle.
