The KLVR and KLVR+ Dialysis Devices for Liver Dialysis in Pediatrics and Adult Patients and MODS Support
Currently Liver Dialysis is no-existent and standard kidney dialysis is highly inefficient. Thrice weekly 4 hours hemodialysis sessions only introduces 7% of marginal uremic toxins clearance. The standard dialysis eliminates mostly water-soluble substances of low or intermediate molecular weight toxins, and very inefficiently removes clinically important uremic toxins “the middle molecules” and the notorious non-dialyzable protein-bound toxins which are prevalent in Liver failure more than kidney failure. Hence, they are very inefficient which explains the very high mortality of patients with acute liver failure, acute on chronic liver failure and end stage liver cirrhosis patients. Transplantation is the only option at this time which is limited to a small percentage of patients due to severe and worsening of graft shortage. Even with availability of standard dialysis, there is high mortality in patients on dialysis!
In this unique device the proper manipulation and permutations of unique dialysis steps and processes such as diffusive, convective and adbsorptive are optimized, maximized and utilized. Every step is highly optimized by combining different membranes and dialysis modalities like Hemodialysis, Hemodiafiltration, Hemoperfusion, Hemofiltration, albumin dialysis and novel lipid dialysis. Specialized membranes and filters are placed together in different orders and their permutations used for optimization and individualization of therapy for Liver or Kidney and Liver dialysis and also MODS patients. Combined with several “special” maneuvers manipulating blood, serum/plasma utilizing plasma separation technology the efficiency of hard to remove toxins are improved several orders of magnitude. Ultimately, performing Liver Dialysis by increasing the free serum concentration of non-dialyzable “protein-bound toxins”!
KLVR has several advantages such as reducing Platelets, and WBCs activation, lower requirement for blood flow rates and blood volume extracorporeally, and specialized and modified dialysate containing charcoal and/or resins and unique lipid dialysis.
KLVR device utilizes the following mechanisms to increase dialysis for kidney and liver dialysis:
1. Reducing Recirculation by using wo accesses one in each limb
2. Reducing dead-space by using plasma to optimize the precious membrane for more efficient dialysis.
3. Increasing the convective dialysis by increasing Ultrafiltration and Internal filtration
4. Increasing the free serum concentration of the protein-bound toxins via dilution with Specialized Replacement Fluids. A couple of 1:4 dilutions via replacement fluids will yield a 1:16 dilution ultimately increasing removal of protein-bound toxins.
5. Use of albumin for albumin dialysis with or without novel lipid dialysis
6. Using specialized dialysate by adding Charcoal and Resins.
The KLVR dialysis device would be constructed by integrating the following components and segments which are as follows:
Replacement Fluid Mixer + Pump RFM Segment
Plasma Separator PS Segment
High Efficiency High Efficacy Dialyzer HED Segment
Hemodiafiltration + Hemodialysis HHD Segment
Hemoperfusion apparatus HP Segment
Albumin dialysis AD Segment
Dialysis Regeneration (optional) DR Segment
Lipid Dialysis (optional) LD Segment
The KLVR+ has the additional membrane specifically for blood oxygenation using extracorporeal membrane oxygenator (ECMO) for patients with heart and lung failure.
Combined, effectively improves inefficiency of Liver/Kidney Dialysis.