Abstract
Background: Chronic liver failure presents a potentially life-threatening event with organ transplantation as the only curative option. The disparity between the number of potential candidates for transplantation and the number of available donor organs is constantly growing and waiting list mortality is increasing. There is still an unmet need of proper clinical management of chronic liver failure patients awaiting transplantation. New solutions of monitoring of patients' health status to assess the individual health risk and prevent deterioration need to be investigated. Methods and Results: D-LIVER is a four year European programme (October 2011-2014) under the seventh framework programme (project number 287596). D-LIVER will provide a complete solution for remote ICT-enabled home monitoring of the chronic liver failure patient awaiting transplantation. Instruments and algorithms that are reliable, long term useable and acceptable by the users will be developed, allowing daily monitoring of physiological parameters and discrete measurements of a defined set of biochemical species. The system will be capable of remote and secure communication of the patient condition to central clinical services. Thus decompensation episodes can promptly be detected and controlled by swift and beneficial treatment. Moreover D-LIVER targets the integration of remote monitoring and control of a bio-artificial liver to replace organ function at the point of need. Until now the clinical needs and the technical requirements were addressed by means of various application scenarios and application diagrams as well as description of user cases and communication structure. Conclusion: D-LIVER will allow remote ICT-enabled health monitoring of chronic liver failure patients in the home environment resulting in a much more efficient treatment and reduction of waiting list mortality. In future, liver function might be replaced properly by means of bio-artificial liver devices until a suitable graft is available. Collected data may also contribute to improvement in the current allocation and waiting list system.
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