TNF and liver failure: Liver failure implies accumulation of a broad spectrum of water-soluble and lipophilic toxins and immune mediators (58, 59).-Oxidized forms of albumin and cytokines, are key factors in the pathogenesis of AOCLF (58, 59).-MARS (DIALIVE) have been described to diminish total bilirubin, biliary acids, BUN, ammonia, TNF-alpha, IL-6, and IL-1beta (60, 61)