To determine the alterations in coagulation and fibrinolysis occurring in patients treated with the liver dialysis device. Patients with advanced liver disease treated with the liver dialysis device were studied immediately before and after the liver dialysis device treatment. A university hospital intensive care unit. Thirteen consecutive patients with advanced liver disease being evaluated for or awaiting liver transplantation. 4-6 hours of liver dialysis treatment for management of hepatic encephalopathy. A panel of coagulation and anticoagulation factors, as well as fibrinolytic and anti-fibrinolytic factors plus measures of activation of inflammation and soluble adhesion factors. The liver dialysis device used was found to be associated with activation of both coagulation and fibrinolytic pathways, activation of inflammation reactants, and an increase in sL-selectin levels. Liver dialysis device activates both coagulant and fibrinolytic pathways, activates inflammatory response, but these responses are limited to the vascular compartment by an increase in sL-selectin levels.