Extracorporeal albumin dialysis for acute-on-chronic liver failure

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on extracoropreal albumin dialysis for acute-on-chronic-liver failure.

NICE has reviewed this guidance and is reassessing the procedure. New guidance will be published as a result.  Until the new guidance is published the NHS should continue to follow the recommendations in the guidance below.

The Interventional Procedures Advisory Committee (IPAC) has considered this procedure again and NICE has issued a consultation document about its safety and efficacy. Consultation has now ended. IPAC will consider the consultation comments and produce a Final Interventional Procedures Document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.

The consultation period for this procedure closed on the 24th June 2009.

If you wish to be updated to any developments with this procedure, you can express an interest here.

Extracorporeal albumin dialysis for acute-on-chronic liver failure involves pumping blood from the body through a thin membrane coated with albumin. Molecules that bind to the albumin membrane are then removed by passing through a charcoal column and an anion exchange, before being reintroduced into the circuit. Both water-soluble toxins (as in renal dialysis) and strongly albumin-bound toxins are removed by this process.

Albumin is purported to have important transport and detoxifications functions, such as the removal of albumin-bound substances, which may ameliorate some of the problems of liver failure.

Special

Digestive system
Therapeutic procedures

Gastroenterology

• British Renal Society
• Intensive Care Society
• British Association for the Study of the Liver
• British Society of Gastroenterology
• Association of Upper Gastrointestinal Surgeons for Great Britain and Ireland

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA