Cell Sources for Bioartificial Liver Support

1996 ◽  
Vol 19 (1) ◽  
pp. 14-17 ◽  
Author(s):  
J. Stange ◽  
S. Mitzner
Keyword(s):  
Plasma Proteins ◽  
Isolated Hepatocytes ◽  
Bioartificial Liver ◽  
The Other ◽  
Liver Support ◽  
Established Cell Lines ◽  
Bioartificial Liver Support ◽  
Cell Sources ◽  
Established Cell ◽  
The One

The present review discusses hepatocyte sources for a bioartificial liver. Intended requirements for cell sources are for example: synthesis of plasma proteins, detoxification and regulation. The need for highly differentiated hepatocytes is stressed. Furthermore, the gap between this objective on the one hand and the real possibilities as they appear today on the other is shown. Alternatives to primarily isolated hepatocytes are discussed, thereby elucidating the limits of established cell lines. In summary, it is postulated that the results expected from a bioartificial liver, are closely related to the source and type of cells used.

scholarly journals Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Klementina Ocskay ◽  
Anna Kanjo ◽  
Noémi Gede ◽  
Zsolt Szakács ◽  
Gabriella Pár ◽  
...  
Keyword(s):  
Liver Failure ◽  
Support Systems ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Bioartificial Liver ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Liver Support ◽  
Bioartificial Liver Support ◽  
The Impact

Abstract Background The role of artificial and bioartificial liver support systems in acute-on-chronic liver failure (ACLF) is still controversial. We aimed to perform the first network meta-analysis comparing and ranking different liver support systems and standard medical therapy (SMT) in patients with ACLF. Methods The study protocol was registered with PROSPERO (CRD42020155850). A systematic search was conducted in five databases. We conducted a Bayesian network meta-analysis of randomized controlled trials assessing the effect of artificial or bioartificial liver support systems on survival in patients with ACLF. Ranking was performed by calculating the surface under cumulative ranking (SUCRA) curve values. The RoB2 tool and a modified GRADE approach were used for the assessment of the risk of bias and quality of evidence (QE). Results In the quantitative synthesis 16 trials were included, using MARS®, Prometheus®, ELAD®, plasma exchange (PE) and BioLogic-DT®. Overall (OS) and transplant-free (TFS) survival were assessed at 1 and 3 months. PE significantly improved 3-month OS compared to SMT (RR 0.74, CrI: 0.6–0.94) and ranked first on the cumulative ranking curves for both OS outcomes (SUCRA: 86% at 3 months; 77% at 1 month) and 3-month TFS (SUCRA: 87%) and second after ELAD for 1-month TFS (SUCRA: 76%). Other comparisons did not reach statistical significance. QE was moderate for PE concerning 1-month OS and both TFS outcomes. Other results were of very low certainty. Conclusion PE seems to be the best currently available liver support therapy in ACLF regarding 3-month OS. Based on the low QE, randomized trials are needed to confirm our findings for already existing options and to introduce new devices.

Bioartificial liver support devices: historical perspectives

2003 ◽  
Vol 73 (9) ◽  
pp. 739-748 ◽  
Author(s):  
Fiona G. Court ◽  
Simon A. Wemyss-Holden ◽  
Ashley R. Dennison ◽  
Guy J. Maddern
Keyword(s):  
Bioartificial Liver ◽  
Liver Support ◽  
Historical Perspectives ◽  
Bioartificial Liver Support ◽  
Liver Support Devices ◽  
Support Devices

Bioartificial liver support: report of the longest continuous treatment with human hepatocytes

2001 ◽  
Vol 33 (1-2) ◽  
pp. 1935 ◽  
Author(s):  
J.M Millis ◽  
D.C Cronin ◽  
R Johnson ◽  
H Conjeevaram ◽  
T.W Faust ◽  
...  
Keyword(s):  
Bioartificial Liver ◽  
Human Hepatocytes ◽  
Continuous Treatment ◽  
Liver Support ◽  
Bioartificial Liver Support

Review of Methods to Remove Protein-Bound Substances in Liver Failure

2002 ◽  
Vol 25 (10) ◽  
pp. 911-917 ◽  
Author(s):  
R.D. Hughes
Keyword(s):  
Liver Failure ◽  
Plasma Proteins ◽  
High Volume ◽  
Toxic Substances ◽  
Albumin Dialysis ◽  
Liver Support ◽  
Excretory Function ◽  
Bioartificial Liver Support ◽  
Wide Range

A wide range of toxic substances accumulates in the circulation of patients with liver failure, including more lipid-soluble substances, which bind to plasma proteins. Serum albumin is the most important binding protein for ligands such as bilirubin and bile acids, which are potentially toxic and can cause apoptosis in astrocytes and hepatocytes respectively in vitro. Resin haemoperfusion was originally investigated to remove these compounds, as well as inflammatory cytokines. Current effective methods for removal of protein-bound compounds in patients with liver failure include high volume plasmapheresis and different forms of albumin dialysis. Bioartificial liver support systems need adsorbent and/or dialysis modules to replace the lack of excretory function.

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