Advances in bioartificial liver assist devices

Area of Science:

• Biomedical Engineering
• Hepatology
• Regenerative Medicine

Background:

• Acute liver failure necessitates innovative treatment strategies.
• Bioartificial liver assist devices (BLADs) offer a potential solution by mimicking liver function.
• Hollow-fiber membrane technology is a key component in current BLAD designs.

Purpose of the Study:

• To review the current state of bioartificial liver assist device (BLAD) development.
• To highlight devices in clinical evaluation and alternative preclinical approaches.
• To identify key engineering challenges in BLAD technology.

Main Methods:

• Review of clinical trial data for four leading BLADs (HepatAssist, ELAD, BELS, BLSS).
• Analysis of preclinical and laboratory-scale studies on alternative hepatocyte culture and perfusion methods.
• Delineation of engineering design considerations for BLADs.

Main Results:

• Four hollow-fiber membrane-based BLADs are in clinical evaluation.
• Various alternative hepatocyte culture and perfusion strategies have been explored.
• Significant engineering challenges remain for xenotransplantation, perfusion, and long-term function.

Conclusions:

• BLAD technology is advancing rapidly, generating clinical interest for acute liver failure.
• Successful clinical translation requires addressing complex engineering and biological challenges.
• Continued research into alternative designs and improved hepatocyte maintenance is crucial.