Support your patient’s liver
Hepatic dysfunction impairs liver functions like detoxification, synthesis, and regulation, leading to high mortality in intensive care unit (ICU) patients. Extra Corporeal Liver Support (ECLS) systems aim to support liver detoxification by clearing hepatotoxic molecules from the blood.
Next-Level Liver Support
One of the main problems with Acute Liver Dysfunction (ALD) is auto-intoxication from substances usually metabolized or excreted by the liver, such as bilirubin, bile acids, ammonia, and others. Liver auto-intoxication and systemic hyperinflammation, which often accompanies ALD, can progress to Multi Organ Dysfunction Syndrome (MODS).
CytoSorb® provides liver toxin removal and immunomodulation (to address auto-intoxication and immune dysfunction).
Liver support by CytoSorb
CytoSorb is a unique technology proven to effectively, safely, and simultaneously reduce elevated levels of cytokines and bilirubin, thereby promoting hemodynamic stability and recovery of liver function. And as a bridging therapy, CytoSorb has been shown to be superior and easier to apply compared to conventional albumin dialysis.
Hemoadsorption has a different mode of action than dialysis-based therapies have, effectively removing excessive levels of cytokines and liver toxins. Early attenuation of auto-intoxication (and hyperinflammation) can help as bridging therapy towards liver recovery or transplantation.
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Removal of:
- Bilirubin
- Cytokines
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Can lead to:
- Improvement of liver function
- Improved clinical outcome
- Hemodynamic stability
CytoSorb can be used to address a variety of challenges associated with liver dysfunction
Manage liver dysfunction
Liver dysfunction can occur in various settings, such as acute-on-chronic liver failure, post-hepatectomy liver failure (PHLF), and acute liver failure.
CytoSorb is a powerful tool to remove bilirubin and other liver toxins efficiently, and to address systemic hyperinflammation via cytokine removal.
Building a vital bridge with CytoSorb
Reduction of systemic inflammation together with support of excretory liver function is intended to bridge to either recovery or liver transplantation
CytoSorb Therapy can help to manage liver dysfunction:
Effective bilirubin removal
Support of hepatic excretory function
Attenuation of hyperinflammation
Ease of setup and use
Acute Liver Failure & Secondary Liver Dysfunction
Treatment Rationale & Guidance
Support the liver by dual targeting. Removal of bilirubin and bile acids. Attenuation of hyperinflammation. Improvement of hepatic encephalopathy. Support bridge to recovery or transplantation
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Break the cycle of auto intoxication
Tomescu et al.Reduces bilirubin and bile acids
In case of liver damage, excretory functions for bilirubin and bile acids get impaired. The rising plasma levels of these toxins further induce hepatic and other organ dysfunctions and thus lead to a worsening of the condition. Getting control on these protein-bound toxins is paramount in the treatment approach for liver dysfunction.
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Control the associated hyperinflammation
Popescu et al.Reduces cytokines and DAMPs/PAMPs
Concomitant high inflammation status paves the way to further complications. While hepatic inflammation is considered the main driver of hepatic tissue damage, systemic hyperinflammation with elevated cytokines and DAMPs induces endothelial damage and metabolic derangements resulting in disorders in micro- and macrocirculation.
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Complement the liver dialysis procedures
Riva et al.Utilizes versatility in liver support applications
In liver dysfunction, extracorporeal support systems fight the intoxication status. Next to dialysis for removal of water-soluble substances, hemoadsorption takes care of the reduction of albumin bound toxins. Contrasting the complex setup of other systems, CytoSorb is easy to integrate into an extracorporeal circuit, fast to start and covers a broad range of substances to be bound.
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Dampen side effects of liver dysfunction
Haselwanter et al.Ameliorates hepatic encephalopathy. Reduces hemodynamic instability.
Beyond the tissue damage, a renown risk of liver failure is hepatic encephalopathy driven by elevated neurotoxins, including ammonia, and hyperinflammation. The grading of this life-threatening condition can be reduced through HA as well as hemodynamic stability improved with declining need for vasopressor agents.
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Protect and restore organ tissue/function
Turan et al.Gains time for organ recovery. Bridges time for organ Tx
Bridging to recovery or liver transplantation is a core objective in the therapy approach. Hemoadsorption can yield time by dually combating hyperinflammation and toxin accumulation
Acute on Chronic Liver Dysfunction (ACLF)
Treatment Rationale & Guidance
Support the liver by dual targeting. Removal of bilirubin and bile acids. Attenuation of hyperinflammation. Improvement of hepatic encephalopathy. Relief of refractory pruritus. Support bridge to recovery or transplantation.
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Break the cycle of auto intoxication
Graefe et al.Removes bilirubin and bile acids
In case of liver damage, excretory functions for bilirubin and bile acids get impaired. The rising plasma levels of these toxins further induce hepatic and other organ dysfunctions and thus lead to a worsening of the condition. Getting control on these protein-bound toxins is paramount in the treatment approach for ALD.
-
Controls the associated hyperinflammation
Haselwanter et al.Reduces cytokines and DAMPs/PAMPs
Concomitant high inflammation status paves the way to further complications. While hepatic inflammation is considered the main driver of hepatic tissue damage, systemic hyperinflammation with elevated cytokines and DAMPs induces endothelial damage and metabolic derangements resulting in disorders in micro- and macrocirculation.
-
Complements the liver dialysis procedures
Scharf et al.Utilizes versatility in liver support applications
In liver dysfunction, extracorporeal support systems fight the intoxication status. Next to dialysis for removal of water-soluble substances, hemoadsprtion takes care of the reduction of albumin bound toxins. Contrasting the complex setup of other systems, CytoSorb is easy to integrate into a extracorporeal circuit, fast to start and covers a broad range of substances to be bound.
-
Dampens side effects of liver dysfunction
Popescu et al.Ameliorates hepatic encephalopathy. Reduces hemodynamic instability. Improves refractory pruritus.
Beyond the tissue damage, a renown risk of liver failure is hepatic encephalopathy driven by elevated neurotoxins, including ammonia, and hyperinflammation. The grading of this life-threatening condition can be reduced through HA as well as hemodynamic stability improved with declining need for vasopressor agents. On top, severe hepatic pruritus can be ameliorated.
-
Protects and restore organ tissue/function
Tomescu et al.Gains time for organ recovery. Bridges time for organ Tx. Reduces subjective suffering / QofL.
Bridging to recovery or liver transplantation is a core objective in the therapy approach. Hemoadsorption can yield time by dually combating hyperinflammation and toxin accumulation. In patients with refractory pruritus, it was shown to persistently reduce sypmtoms and relieve individual suffering.
Additional Information
- Haselwanter et al., Sci Rep 2024; 14(1):11309
- Turan et al., Biomedicines 2024; 12(1):67
- Riva et al., J Art Orgs 2023; epub
- Popescu et al., J Clin Med 2023; 12(6):2258
- Greimel et al., Ann Intensive Care 2023; 13(1):110
- Tomescu et al., Int J Artif Organs 2021; 4(8):560-564
- Jansen et al., Crit Care 2023; 27(1):117
- Riva et al., J Artif Organs 2024; 27(3):261-268
- Forni et al., BMC Neph 2024; 25(1):247
- Dhokia et al., JICS, 2019; Vol. 20(2):174-181
- Frattari et al, Blood Purif 2019; 47(suppl 4):3-37
- Scharf et al., Scientific Reports 2021; 11:10190
- Graefe et al., Sci Rep 2024; 14(1):21762
- Albrecht et al., Blood Purif 2024; 52(2):88-95
- Chavez et al. Crit Care 2016; 20(1):135
Voices around the world
Access Healthcare Professionals Area
This area is for Health Care Professionals only and provides reports about clinical experiences gained during the use of CytoSorbents products. The information presented reflects the opinions and procedural techniques of individual physicians and is not intended as medical advice. Physician experience, risks, patient outcomes and results may vary. This content is intended for Health Care Professionals outside the United States and Canada as CytoSorb has not yet been approved or cleared in the United States or Canada for any indication, except under an Emergency Use Authorization (EUA) by the US FDA.