The ALIVER Consortium has developed and optimized a novel liver dialysis device, DIALIVE. The DIALIVE device has been granted patent protection and is based upon the discovery that albumin, a circulating protein involved in detoxification, is reduced irreversibly in function, and endotoxemia contributes to the increased risk of infection in liver failure. DIALIVE incorporates albumin removal and replacement, and endotoxin removal. In animal models of liver failure, DIALIVE was shown to be easy to use, safe, reduces endotoxemia and, improves albumin and immune function and thus survival. The ALIVER Consortium, has performed clinical trials of DIALIVE in patients with acute-on-chronic liver failure (ACLF). Upon being granted regulatory and ethics approval a trial has been conducted to define DIALIVE’s safety in ACLF patients in 18 European hospitals; define health economic benefits to the EU and develop a reimbursement strategy.