Liver dialysis, which is used in patients who have acute liver problems, is either as a bridge to transplant or a filter for an overdose of drugs. In cases of liver failure, dialysis is a stopgap measure only, and the patient will need a transplant within a short period of time. This contrasts with kidney dialysis, which can be repeated over weeks, months and sometimes years while a patient waits for a kidney to become available. A doctor might recommend liver dialysis if the benefits outweigh the risks in a patient who has acute or chronic liver failure.
During the liver dialysis procedure, the patient's blood passes through a series of external filters. These filters remove the toxins that the overloaded and failing liver cannot, thereby returning the patient's blood chemistry to more normal levels. Classically, the dialysis machine consists of a charcoal-filled chamber through which the blood can pass for filtration. The patient will need to remain stationary during the procedure and might experience some discomfort.
Patients in liver failure because of liver disease can die as their overloaded livers filter out fewer and fewer toxins from the blood. Liver dialysis might help in their cases by temporarily taking over to clean up the patient's blood. The patient also can be given a nutrient mix to prevent a loss of nutrients in the charcoal bed of the filter. This treatment typically is given when the patient does not respond to hospitalized treatment for at least 24 hours and is on a transplant list waiting for a new liver.
Another use for liver dialysis is in the treatment of drug overdoses. If the drug is dialyzable, as is the case with medications such as acetaminophen, the patient might benefit from liver dialysis. The therapy can remove the drug from the patient's bloodstream and take the load off the liver. This gives the patient a chance to recover from the overdose. The liver is a surprisingly robust, adaptable organ, and it might bounce back after a period of healing.
When a doctor recommends liver dialysis for a patient, it can be helpful for the patient to ask why the procedure is being recommended and what the benefits are. The patient might want to find out how long he or she can use dialysis to take over for a failing or damaged liver and what the potential risks are for him or her. A patient who is waiting for transplant, for instance, might still die before liver becomes available, because the dialysis can help out the liver, but it will not completely take over all of the liver's functions.