Enhancing Efficacy of Biologic-DT Liver Assist Device

Acute hepatic failure (AHF) with Stage 4 coma is a serious illness with over 60% mortality whentreated with supportive therapy. The BioLogic-DT is an extracorporeal liver support device in whichblood passes through cellulosic packages with a suspension of powdered charcoal and cation exchangersorbents on the opposite side. This device effectively removes many organic toxins of 100-300 m.w.including aromatic amino acids, but removes only small amounts of ammonia. It does not increasebranch chain amino concentrations in blood. Nonetheless, over 80% of liver failure patients improvephysiologically and neurologically during treatment with the device; most recover liver function orproceed to liver transplant. In the current study, we will add acid-filled liquid membrane capsules to thesorbent suspension to remove ammonia, and will pre-load the charcoal with branch chain amino acidsto return these amino acids to the patient during treatment. In vitro tests will determine.the effect ofthese sorbent changes on ammonia removal and branch-chain generation, and will determine whetherthere is any loss of organic toxin removal. Phase II clinical studies will determine whether the newchemical functions of the sorbent improve the treatment of patients with hepatic coma.