A critical issue of the clinical syndrome in liver failure is the accumulation of toxins not cleared by the failing liver. Based on this hypothesis, albumin dialysis is used to remove those substances. Albumin dialysis with recirculation (MARS) is the most used system but required specific system and expert environment. Alternative system without recirculation (SPAD) is less expensive and can be realised in critical care services trained to extrarenal epuration. The primary objective of this study is to compare biological and clinical efficacy, pulsatility index of middle cerebral artery modification and tolerance of both systems. This is a prospective, open, cross-over comparative study of two albumin dialysis system. Each patient will receive the two systems in an randomly assessed order. Patients are divided up according to bilirubin plasmatic level. (250Āµmol/L to 400 Āµmol/L and \>400Āµmol/L).
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Comparison of total plasmatic bilirubin level before and after two albumin dialysis systems : with recirculation (MARSā¢ system) and without recirculation (SPADā¢ system)
Timeframe: Before and at the end of a MARSā¢ dialysis (8h) and before and at the end of a SPADā¢ system dialysis (10h). Participants will be followed for the duration of critical care stay, an expected average of 1 week