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4-in-1 support therapy for multiple organ failure treatment

ADVITOS GmbH is the world’s only 4-in-1 organ support therapy for the treatment of multiple organ failure.

The ADVOS therapy is the world’s first method for the combined multi-organ support of liver, lung, kidney, and acid-base balance. Based on the principle of albumin dialysis, the ADVOS procedure allows extracorporeal fluid-based elimination of CO2, hepatic toxins, water-soluble and protein-bound nephrotoxins, as well as the correction of metabolic and respiratory acidosis. The ADVOS method works with typical dialysis accesses and flow rates and does not require any gas exchangers for CO2 elimination.

Multi-organ failure (MOF) is one of the most difficult problems in critically ill patients. Despite significant progress in the treatment of MOF, the mortality rate remains high. About 500,000 patients die every year in Western Europe and the USA on intensive care units (ICU) due to multi-organ failure. Due to the COVID-19 pandemic this numbers increased to over 750,000 deaths in 2020.

The first and only 4-in-1 device: simultaneous support for all detoxification organs

  • Liver support: removal of hepatic toxins
  • Lung support: extracorporeal CO₂ removal in low-invasive setting
  • Kidney support: removal of water-soluble as well as protein-bound nephrotoxins
  • Blood pH management: stabilising acid-base balance by direct removal of acid resulting in acidosis correction

Clinical results: improved organ function through effective detoxification and blood pH correction

The ADVOS therapy is a safe and effective method for the treatment of multiple organ failure based on the principles of haemodialysis. Fuhrmann et al. published a paper1 in 2020 showing first clinical data of 34 critically ill patients with multi-organ failure who received 102 ADVOS treatment sessions in the Department of Intensive Care Medicine of the University Medical Centre Hamburg-Eppendorf. The ADVOS therapy was able to remove water-soluble and albumin-bound substances, correct acid-base imbalances, remove CO2 and improve the hemodynamic status in patients with liver failure, septic shock, or acute respiratory distress syndrome (ARDS) in need of extracorporeal support. Furthermore, the authors conclude that the wide therapeutic range of the ADVOS therapy is convincing.

Similar results are shown in a case report from Huber et al.2, who treated a COVID-19 patient suffering from multi-organ failure with the ADVOS treatment. Patients with severe COVID-19 develop lung failure and require oxygenation, which is often performed in intensive care units. Other secondary diseases include acute respiratory distress syndrome (ARDS), hemodynamic disorders, and shock. The subsequent multi-organ dysfunction and failure is the main cause of death in coronavirus infections.

Key facts

  • Only CE marked 4-in-1 device to provide multi-organ support for liver, kidney, lung, and blood pH management
  • Clinical results: ADVOS treatment improves survival in multi-organ failure from 10% up to 50%
  • High performance and long-lasting efficacy of detoxification
  • Low-invasive and safe method: no large-lumen catheter necessary, blood flow, and volume like in regular haemodialysis
  • Correction of acid-base imbalances by direct removal of acids; treatment of heavier metabolic and respiratory acidosis without bicarbonate
  • Reduced operator effort

This project has received funding from the European Union’s Horizon 2020 research and innovations programme under grant agreement No 880349 and 961745.


  1. Fuhrmann, V., Weber, T., Roedl, K. et al. Advanced organ support (ADVOS) in the critically ill: first clinical experience in patients with multiple organ failure. Intensive Care 10, 96 (2020). https://doi.org/10.1186/s13613-020-00714-3 https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-00714-3
  2. Huber W, Lorenz G, Heilmaier M, et al. Extracorporeal multiorgan support including CO2-removal with the ADVanced Organ Support (ADVOS) system for COVID-19: A case report. The International Journal of Artificial Organs. 2021;44(4):288-294. doi:10.1177/0391398820961781 https://journals.sagepub.com/doi/full/10.1177/0391398820961781

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