London: A novel dialysis device developed for treating severe liver failure has shown to be safe and effective, according to results of the first in-patient trial, led by researchers including those of Indian-origin. Acute-on-chronic liver failure (ACLF) occurs in 30 per cent of hospitalised cirrhosis patients, leading to over one million deaths worldwide each year. Currently the only potential treatment for this condition is liver transplantation, which is available to very few patients The new DIALIVE device was found to be safe and was associated with substantial improvement in the severity of symptoms and organ function in a greater proportion of patients with ACLF, when compared with patients receiving standard of care. In the trial, 32 patients were treated with DIALIVE or standard of care for up to five days and the outcomes were recorded at days 10 and 28. The results showed that DIALIVE treatment was associated with significantly faster reversal of ACLF compared with standard of care, with ACLF resolving in about twice the number of patients. DIALIVE treatment also led to a significant reduction in endotoxins, which are released when bacteria die, and improved albumin function. "It gives me enormous pleasure to see the promise of this novel liver dialysis device for the treatment of acute-on-chronic liver failure," said Dr Banwari Agarwal, Chief Investigator of the DIALIVE trial from the Royal Free Hospital, UK. "The intervention has the potential to transform the care provided to the ever-increasing number of patients and their families suffering from the effects of living with what is essentially a terminal illness for many. "It has the potential to transform the therapeutic options available to clinicians across the world for patients with ACLF," said Agarwal, also the Associate Professor at the University College London. Further, the trial results also showed improvements in biomarkers of systemic inflammation, such as cytokines, endothelial function and markers of cell death. Despite receiving as little as three days' treatment, patients whose ACLF resolved remained in remission for 28 days afterwards. The next step will be a larger clinical trial, which if successful could see DIALIVE approved for clinical use within the next three years, said researchers at UCL's Institute for Liver and Digestive Health, who invented the device. Worldwide, it is estimated that there are around 100 million people living with cirrhosis of the liver and 10 million who have cirrhosis plus an additional complication. Around three million of those individuals have ACLF, a condition that can cause liver function to suddenly decline, placing individuals at high risk of short-term death. —IANS

A novel dialysis device developed for treating severe liver failure has shown to be safe and effective

New Dialysis Device Safe & Effective For Treating Severe Liver Failure

Washington: Researchers from UCL, the Royal Free Hospital, UCL spin-out Yaqrit, and their colleagues have completed the first successful in-patient study of liver dialysis. When compared to patients receiving standard of care, the DIALIVE device, developed by researchers at UCL's Institute for Liver and Digestive Health, was found to be safe and associated with significant improvement in the severity of symptoms and organ function in a greater proportion of patients with acute-on-chronic liver failure (ACLF). The next step will be a larger clinical trial, which if successful could see DIALIVE approved for clinical use within the next three years. Worldwide, it is estimated that there are around 100 million people living with cirrhosis of the liver and 10 million who have cirrhosis plus an additional complication. Around three million of those individuals have ACLF, a condition that can cause liver function to suddenly decline, placing individuals at high risk of short-term death. The UK sees around 15,000 ACLF patients each year whose treatment costs the NHS in the region of £100,000 per patient, without improving their mortality risk. The liver is a complex organ that performs over 500 functions, including removal of harmful substances from the blood and absorbing nutrients. One of its roles is to produce large quantities of a protein called albumin, which travels around the body acting as a sort of 'mobile liver' that absorbs unwanted substances. But when liver function is seriously reduced, such as through alcohol abuse, obesity or viral infection, less albumin is produced. In ACLF, its function is also seriously impaired; liver cells die and the gut begins to leak bacteria into the bloodstream, which can cause an inappropriate immune response and multiorgan failure. DIALIVE was designed to address these mechanisms that drive mortality of ACLF patients. This study is the first-in-human randomised, controlled clinical trial of a liver dialysis device. It was performed with the aim of assessing the safety of DIALIVE to treat ACLF patients and to observe its clinical effects. A total of 32 patients were treated with DIALIVE or standard of care for up to five days and the outcomes were recorded at days 10 and 28. The results showed that DIALIVE treatment was associated with significantly faster reversal of ACLF compared with standard of care, with ACLF resolving in about twice the number of patients. This clinical improvement was associated with significant impact on the mechanisms underlying the development of ACLF. DIALIVE treatment led to a significant reduction in endotoxins, which are released when bacteria die, and improved albumin function. Biomarkers of systemic inflammation, such as cytokines, endothelial function and markers of cell death, all improved. Despite receiving as little as three days' treatment, patients whose ACLF resolved remained in remission for 28 days afterwards. Dr Banwari Agarwal, Chief Investigator of the DIALIVE trial from the Royal Free Hospital and Honorary Associate Professor at the UCL Division of Medicine, said: "It gives me enormous pleasure to see the promise of this novel liver dialysis device for the treatment of acute-on-chronic liver failure. The intervention has the potential to transform the care provided to the ever-increasing number of patients and their families suffering from the effects of living with what is essentially a terminal illness for many. It has the potential to transform the therapeutic options available to clinicians across the world for patients with ACLF." The next step will be to conduct a larger trial with more patients to confirm DIALIVE's safety and effectiveness. One of the additional metrics to be assessed will be the impact on patient mortality of DIALIVE versus other available care. Professor Rajiv Jalan (UCL Institute for Liver and Digestive Health, part of the UCL Division of Medicine), inventor of DIALIVE and co-founder of Yaqrit, said: "As academics it can be difficult to define a disease then translate this knowledge into a clinical solution that makes a real difference to people's lives. So the results of the DIALIVE trial are an emotional moment, which wouldn't have been possible without scientific collaboration between the UK, European colleagues and funding from the European Commission. My hope is that within a few years we will start to fulfil the urgent unmet need for treating acute-on-chronic liver failure and improve outcomes for patients." Carrie Morgan, Senior Vice President of Clinical Operations at Yaqrit, said: "We are at an exciting stage of the development of DIALIVE and the results of this trial are extremely encouraging. Our unwavering focus remains on putting the individual at the centre of our efforts, working tirelessly towards a brighter future for all those impacted by chronic liver disease." The trial is the latest step on a long journey for UCL and Royal Free Hospital researchers, that began with the identification of acute-on-chronic liver failure as a distinct clinical entity in 2001. This work led to DIALIVE, which was invented by Professors Rajiv Jalan and Nathan Davies, based in the Liver Failure Group at UCL's Institute for Liver and Digestive Health, part of UCL Division of Medicine. The intellectual property behind the technology was patented by UCL in 2009 and licensed to a spin-out company, Yaqrit. Pre-clinical testing was supported by grants from NIHR and MRC and this trial was made possible by an EU Horizon 2020 grant. This research was funded by the European Union's Horizon 2020 research and innovation programme (grant agreement number, 733057). *Dialysis is a technique to clean the blood of harmful substances, more familiar in the treatment of those with reduced or no kidney function. Kidney dialysis patients must undergo treatment for several hours each day in order to live. Due to the liver's regenerative qualities, however, it is expected that liver dialysis will be able to provide longer term benefits after a short stint of treatment lasting several days. —ANI

Researchers from UCL, the Royal Free Hospital, UCL spin-out Yaqrit, and their colleagues have completed the first successful

Liver Dialysis Device Proved Safe, Effective For Treating Severe Liver Failure: Research

Thane: A two-month-old male infant landed in the PICU on a ventilator after developing severe infections and acidosis due to cow milk feeding, but was saved after nearly four weeks of treatment, medicos at the Wockhardt Hospitals in Mira Road said.
The infant, identified as Ansh Raut, was rushed to the hospital in late April in a critical condition with difficulty in breathing and was put on a ventilator in the Paediatric ICU, given medication and dialysis.
Wockhardt Hospitals’ Paediatric Dr. Ankit Gupta said that the baby was in a serious state, unresponsive, and having difficulty in breathing with oxygen level dropping to just 80.
The team found that since the new mother was not lactating enough, she had put her baby on a cow milk diet which triggered the medical problems.
“This is a rare condition. Cow or buffalo milk is not recommended for young infants as their digestive systems struggle to process it, leading to bacterial overgrowth that increases ammonia and excessive acidity in body fluids,” said Dr. Gupta.
The child’s pH levels came to 6.9, below the normal range of 7.4 and though he was administered medicines it failed to reduce the high acid levels in the body.
“His toxic metabolic ammonia levels exceeded 700, such high ammonia can have deleterious effects on the brain. He required dialysis for a week. The methaemoglobin levels were significantly elevated at 30, against the normal 1, and its potential harmful effects include Breathing difficulty, fits, cardiac rhythm abnormalities,” explained Dr. Gupta.
After a long treatment of nearly a month, the child was discharged in May and his condition was monitored for the next few months.
Dr. Gupta said that during this period, the child achieved developmental milestones appropriate for his age and resumed regular feeding without any noticeable symptoms remaining.
“Now, the baby is now doing well, but lack of prompt treatment could have led to complications like brain damage or even death,” warned the doctor.
Dr. Gupta further advised: “Mother’s milk is a God gift and exclusive breastfeeding is always advised for babies for the first 6 months. If mothers are facing any difficulty, then they should get medical help for the same.”
Now, the mother has also started lactating sufficiently and the child is on breastfeeding and other feeds as advised by the medicos.
—IANS

A two-month-old male infant landed in the PICU on a ventilator after developing severe infections and acidosis

Thane: Cow milk lands 2-month-old infant on ventilator; saved

Washington [US]: According to one study, people with acute kidney impairment who require outpatient dialysis after being discharged from the hospital receive the same care as those with the more common end-stage kidney disease. However, some dialysis patients with acute kidney injury may be able to recover. Patients with the latter diagnosis, which is generally caused by long-standing hypertension or diabetes, must either remain on dialysis for the rest of their lives or obtain a replacement kidney.
The findings were reported in the Journal of the American Society of Nephrology. “For those who have the potential to recover, remaining on dialysis may place them at unnecessary risk for heart disease, infection, organ damage and death,” said first author Ian E. McCoy, MD, of the UCSF Division of Nephrology. Less than a quarter of patients in a typical midsize dialysis centre have acute kidney injury. It may result from acute infection or shock, causing reduced blood flow to the kidneys, as well as major surgeries and chemotherapy agents that are toxic to the kidneys. In the study, researchers tracked data from 1,754 patients with acute kidney injury and 6,197 patients with end-stage kidney disease at outpatient dialysis centres. Although lab tests suggested acute kidney injury patients needed less dialysis, the two groups were treated largely the same. Both were started on thrice-weekly dialysis, and the large majority of patients in both groups were not tested for kidney functioning in the first month of treatment. “More research is needed on safe weaning strategies,” said McCoy. “If a patient is weaned off too quickly, they could become short of breath, or they could develop c that can increase the risk of dangerous heart rhythms.
“On the other hand, continuing dialysis unnecessarily is also risky, since patients experience high rates of heart disease, infection and mortality,” he said. For kidney specialists taking care of acute kidney injury patients and dialysis providers operating the patient-centres"&amp;gt;patient-centres"&gt;outpatient centres, there are powerful disincentives to wean patients off dialysis, McCoy said. “Deprescribing benefits the health care system, but not the dialysis provider, who will have an empty chair that is not easy to fill. At the same time, kidney specialists lose a multidisciplinary support team of nurses, dieticians and social workers when a patient recovers enough to discontinue dialysis. “Kidney specialists are also paid less by insurance for non-dialysis care even though managing a patient with borderline kidney function is more time-consuming and riskier than managing them on thrice-weekly dialysis. For these reasons, the default path of least resistance may be to continue dialysis.” Approximately half of the patients neither died nor discontinued dialysis by the end of the study. For them, the future looked uncertain, said Chi-yuan Hsu, MD, senior author and chief of the UCSF Division of Nephrology. “After about three months of dialysis, they almost always are treated like they will remain on dialysis indefinitely,” he said. “Doctors don’t seem to pay as much attention as they can to monitoring for early, subtle signs of recovery. When someone’s kidney function is at 30%, it’s obvious that they do not need dialysis, but when it’s subtle, it requires skill, attention, careful discussion with the patient and willingness to assume some risk in the weaning process,” said Hsu. “We suspect many doctors stop dialysis only when the signs are blindingly obvious.”  The worst-case scenario is a patient who may have recovered just enough kidney function to wean but has remained on dialysis. Drops in blood pressure with repeated dialysis may further inflict damage to the vulnerable kidneys driving kidney function below the threshold believed to be required for weaning, said McCoy. “The patient may now be facing dialysis for the rest of their life or end up needing a transplant, if they are well enough to be a candidate.”
—ANI

According to one study, people with acute kidney impairment who require outpatient dialysis after being discharged from the hospital receive the same care

Quick dialysis may be most beneficial to some kidney patients: Study

Roorkee (The Hawk): The Indian Institute of Technology Roorkee has signed technology transfer agreement with M/s Permionics Global Technologies, Vadodara, Gujarat, India for licensing of three innovative, environmentally sustainable Technologies based on electro membrane process of caustic production from silica-rich washing-soda solution (green liquor of soda pulping process) with potential scope of eliminating staple burning issues in paddy/wheat fields   The technologies are developed by Prof. Sujay Chattopadhyay and Priyabrata Mandal, Priya Goel and Bhuvanesh E. from the of the Department of Polymer and Process Engineering, IIT Roorkee., these patented technologies EED (electro-electro dialysis) setup eliminates silica issues and solid waste generation commonly encountered in conventional lime-based causticization techniques along with continuous co-generation of hydrogen gas, the source for clean energy generation. SERB (IMPRINT-II) and M/s STAR Paper Mills, SRE were the funding agencies for the research projects executed at IITR.   Speaking about the technology, Mr Satyajai Mayor, Managing Director, Permionics, said IIT Roorkee's technology transfer is crucial for innovation and sustainable development, introducing efficient production processes and eco-friendly solutions, benefiting academia, industry, and society as a whole. By leveraging the research and innovations developed at institutions like IIT Roorkee, we can create a brighter future.   Speaking on the collaboration with Permonics, Prof. Akshay Dvivedi, Dean Sponsor Research and Industrial Consultancy (SRIC), IIT Roorkee, said, By aligning their efforts towards sustainability, IIT Roorkee and Permionics are contributing to a more resilient and eco-conscious future, where technological progress goes hand in hand with environmental stewardship. The collaboration between Permionics and IIT Roorkee, in our opinion, is a prime example of the way research institutions and industry can work together to foster innovation while emphasizing sustainability.   Prof. K.K. Pant, Director, IIT Roorkee, highlighted Sustainable development is crucial in today's world, and advancements like more efficient and environmentally-friendly production processes can make a significant difference. These technologies transfer not only benefit academia and industry but also contribute to the well-being of society as a whole It's admirable these efforts such as this are assisting in laying the foundation for a more sustainable future.

IIT Roorkee collaborates with Permionics for tech transfer of sustainable processes in caustic production, reducing environmental impact and advancing clean energy generation.

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Tag : Dialysis

New Dialysis Device Safe & Effective For Treating Severe Liver Failure

Inam Ansari

The Hawk

Tag : Dialysis

New Dialysis Device Safe & Effective For Treating Severe Liver Failure

Inam Ansari

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