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 <i>in vitro</i> along with significant biosafety, anticoagulant properties, and antibacterial activity against <i>Staphylococcus aureus</i> and <i>Escherichia coli</i>. 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.