What is the d-LIVER Project?
d-LIVER is a four year project, funded by the ECs FP7 programme, developing technology to benefit patients with advanced liver disease. d-LIVER should result in improved care delivery leading to better patient quality of life and reduced costs of management. 14 partners across Europe are collaborating to provide a home monitoring system for patients with advanced liver disease alongside the development of a bio-artificial liver for potential use as an extracorporeal liver assist device. More details about each of these two strands of d-LIVER are given separately below.
d-LIVER Home Monitoring
The Clinical Need
We recognise that management of advanced liver disease can be complex: episodic decompensation, for example with ascites or hepatic encephalopathy, can occur unpredictably and often results in emergency admission to hospital. After inpatient treatment and stabilisation, patients are usually discharged to out-patient follow-up shared between primary and secondary care. Unfortunately, in spite of this follow-up, decompensation often recurs resulting in readmission to hospital. This cycle contributes to poor patient quality of life and leads to high treatment costs. d-LIVER aims to break the cycle by providing frequent, near-patient monitoring.
The d-LIVER Solution
d-LIVER home monitoring will allow regular monitoring of a variety of measurements, including blood parameters, physiological signs and cognitive testing. These will be carried out by patients independently in the home environment, but monitored remotely by clinicians. Semi-automated decision support will allow optimisation of treatment, for example diuretic therapy for ascites or laxatives for hepatic encephalopathy. It is envisaged that this approach will improve care through early detection or prevention of decompensation. Improved quality of life should result from reduced hospital admissions, improved clinical condition and greater self-efficacy.