The NHS is set to begin a groundbreaking clinical trial of a new medical device that could dramatically improve survival rates for patients with a deadly form of liver disease. The treatment, known as Dialive, acts like a form of dialysis for the liver, cleaning a patient's blood of harmful toxins.
A Life-Threatening Condition with Few Options
Acute-on-chronic liver failure (ACLF) is a severe and rapidly progressing condition often linked to obesity, alcohol misuse, and hepatitis. It causes multiple organs to fail, with patients typically requiring intensive care. Alarmingly, three out of four people are only diagnosed when it is already life-threatening.
The prognosis is stark: seven out of ten patients die within 28 days. A liver transplant is currently the only way to reverse the disease, but very few sufferers are eligible for this major surgery, creating a desperate need for new, effective treatments.
How the Dialive 'Liver Support System' Works
The Dialive device is described as an "intensive care liver support system". It functions in a similar way to kidney haemodialysis. Patients are connected to the machine, which filters their blood.
Its key action is to remove dysfunctional albumin – a vital protein produced by the liver that becomes corrupted when the organ fails – and replace it with clean, functional albumin. By cleansing the blood of accumulated toxins, the device aims to halt further damage, allow the liver to regenerate, and help other organs recover.
The UK-Wide Trial and Its Potential Impact
The government-funded National Institute for Health and Care Research (NIHR) is backing the £2.2 million trial, which will involve 72 seriously ill patients across 13 major UK teaching hospitals. The study is randomised and controlled, beginning in early 2025.
Participants, who will already be suffering from two or more organ failures, will receive treatment sessions on their first three days in hospital, with up to four further sessions within ten days.
This large-scale trial follows a promising earlier safety study in 2023. In that research, ten out of fifteen patients treated with Dialive saw their ACLF reversed, compared to just five out of fifteen receiving standard care. Those on Dialive also recovered more quickly.
Professor Rajiv Jalan, a senior liver specialist at University College London and co-principal investigator, founded Yaqrit, the UCL spinout company that developed Dialive. He stated: "Our goal is to demonstrate that we can resolve life-threatening ACLF more often and faster than standard care... Dialive cleans the blood of toxins that accumulate because the liver is not working and therefore prevents further damage and allows the liver to regenerate."
Dr Rohit Saha, a consultant at London's Royal Free Hospital and another lead investigator, said the device "offers new hope" and could provide the first new treatment path in decades for the sickest liver patients.
The first hospitals to recruit will be King’s College Hospital and University College London Hospital in the capital, and the Queen Elizabeth Hospital in Birmingham.
A Growing Health Crisis in the UK
The trial addresses a significant and growing public health challenge. Liver disease, driven by soaring obesity rates, alcohol consumption, and hepatitis, has quadrupled in prevalence in the UK over the past 50 years. An estimated 2 million people now live with some form of liver disease, with around 60,000 having cirrhosis, which puts them at high risk of developing ACLF. Liver disease claims over 12,000 lives annually in the UK.
Professor Mike Lewis, NIHR Scientific Director for Innovation, emphasised the trial's importance: "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 stay. This is taxpayer-funded research at its best."
If proven effective, Dialive could become the world's first successful form of liver dialysis, transforming care for thousands of patients and reducing the urgent reliance on scarce donor organs for transplantation.
