MAB assisted in data analysis and manuscript development. DJM assisted in the device engineering, device testing,

data collection and analysis, and manuscript preparation. TAN assisted in data collection and manuscript development. AL assisted in data collection and data analysis. WBM assisted in manuscript development and statistical analysis. All of the authors have read and approve of the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/10/11/prepub Acknowledgements Inhibitors,research,lifescience,medical This paper represents the views of the authors and is not intended to represent the views of the University of Nebraska Medical Center, the Department of Veterans Affairs, or Penn State College of Medicine. Financial support for this effort was provided by the Inhibitors,research,lifescience,medical Telemedicine and Advanced Selleck Alisertib Technology Research Center (TATRC), Fort Detrick, MD.
Acute liver failure is usually fatal, and in the US, the mortality rate remains as high as 30% in adult patients [1]. Although liver transplantation for acute liver failure has increased the survival rate markedly, the limited supply of suitable livers implies that transplantation is not

available to all patients; 22.7% of patients who were listed for transplantation die awaiting transplantation 3 days after being listed (range 1-6 days). On Inhibitors,research,lifescience,medical the Inhibitors,research,lifescience,medical other hand, 45% of patients with acute liver failure survive with medical therapy alone without liver transplantation [1]. It is thought that a good survival rate can be achieved by establishing an artificial liver support (ALS) system that reliably compensates liver function until the liver regenerates or a patient undergoes transplantation. Although various attempts have been made to develop an ALS system, there is no consensus about the best method [2,3]. A combination of hemodiafiltration (HDF) and plasma exchange has been frequently used in patients with acute liver failure in Japan, and this method results in improvement of consciousness in 90% or more of cases Inhibitors,research,lifescience,medical [4]. However, HDF is complex and is not available

in general facilities. Moreover, there much are economical problems, the practical therapy is often shortened or limited in efficiency because of the cost. Infusion-free HDF “on-line HDF,” was developed with the purpose of solving these problems [5]. On-line HDF markedly reduces the cost of blood purification therapy and simplifies the setup of the dialysis monitor. A number of clinical benefits of this method in the treatment for chronic renal failure were reported, especially the superior efficiency removing middle molecules [6-12]. We introduced a new ALS system, on-line HDF, in patients with acute liver failure. Here, we report our experience in a substantial number of patients with acute liver failure treated with this ALS system.