Online hemodiafiltration in the treatment for acute liver failure

Abstract

Artificial liver support is an essential bridging treatment of acute liver failure until the patient recovers or receives organ transplantation. In Japan, organ donors are few； therefore, the mainstay treatment of acute liver failure is intensive medical care under artificial liver support. Artificial liver support requires patients to remain alert and in good general condition for 2 weeks. Under such special condition, artificial liver support with excellent detoxification capacity was originally developed. Online hemodiafiltration (HDF) with a high-performance membrane and high-volume buffer is the most promising method. Under treatment with online HDF, more than 90% of patients regain alert consciousness. To standardize online HDF as a treatment of acute liver failure, a specific dialysate for liver failure should be developed and guidelines for fluid balance and vascular access should be established.