Hemostatic modulation with the liver dialysis device in humans with advanced liver disease.

Background/aims: To determine the alterations in coagulation and fibrinolysis occurring in patients treated with the liver dialysis device.

Methodology: Patients with advanced liver disease treated with the liver dialysis device were studied immediately before and after the liver dialysis device treatment.

Setting: A university hospital intensive care unit.

Patients: Thirteen consecutive patients with advanced liver disease being evaluated for or awaiting liver transplantation.

Intervention: 4-6 hours of liver dialysis treatment for management of hepatic encephalopathy.

Outcome Measures: A panel of coagulation and anticoagulation factors, as well as fibrinolytic and anti-fibrinolytic factors plus measures of activation of inflammation and soluble adhesion factors.

Results: The liver dialysis device used was found to be associated with activation of both coagulation and fibrinolytic pathways, activation of inflammation reactants, and an increase in sL-selectin levels.

Conclusions: Liver dialysis device activates both coagulant and fibrinolytic pathways, activates inflammatory response, but these responses are limited to the vascular compartment by an increase in sL-selectin levels.