Engineering a biocompatible chitosan/MOF aerogel for hyperbilirubinemia treatment in liver failure

Liver failure, marked by a rapid or progressive decline in liver function, leads to complications such as hyperbilirubinemia and infections, contributing to approximately 2 million global deaths each year. Current hemoperfusion methods for hyperbilirubinemia treatment are limited by their low adsorption selectivity and inadequate biosafety, necessitating better treatments. In this study, a chitosan-based HKUST-1 aerogel (HC) was developed as a highly selective, biosafe, and antibacterial adsorbent. The integration of HKUST-1 with chitosan formed an aerogel that achieved high bilirubin adsorption in vitro along with significant biosafety, anticoagulant properties, and antibacterial activity against Staphylococcus aureus and Escherichia coli. In an animal model of hyperbilirubinemia, the HC aerogel demonstrated 42.4% bilirubin clearance from whole blood. These findings suggest that the HKUST-1/chitosan aerogel is a promising candidate for liver failure treatment, effectively combining bilirubin adsorption with infection control in complex blood environments.