Liver failure is a severe life-threatening condition that can present acutely or chronically. Unlike kidney failure, there is no long-term replacement treatment apart from liver transplantation. Liver transplantation is expensive, requires a donor, and involves a major operation. As it takes at least one week to organise an appropriate liver transplant, liver dialysis is used as a bridge to liver transplantation for some patients with acute liver failure to support him/her through his/her liver failure until transplantation can be performed. Patients have been treated even up to one month while waiting for suitable living donors.
Liver dialysis is performed in the ICU in our dedicated Parkway Asian Transplant Unit, using a non-biological liver dialysis device known as the Molecular adsorbing re-circulating system (MARS™). It is the most commonly used device and it comes as an intermittent device or continuous device. Its charcoal-based system adsorbs the toxins, providing a detoxifying function without any contribution of the normal liver synthetic function. It may be coupled with a plasma separator and there may also be an albumin dialysate. The system usually has some way of trying to renew the cartridges to prolong its lifespan. This device has been utilised extensively at AALC for several years.