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Biologic liver support: optimal cell source and mass.

E Morsiani1, M Brogli, D Galavotti

  • 1Department of Surgery, Sant'Anna University Hospital, Ferrara, Italy. mse@dns.unife.it

The International Journal of Artificial Organs
|November 29, 2002
PubMed
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Bioartificial liver (BAL) devices require specific cell types and quantities for effective hepatic support in acute liver failure (ALF). The choice of hepatocytes and sufficient cell mass are critical for BAL treatment success.

Area of Science:

  • Hepatology
  • Biotechnology
  • Regenerative Medicine

Background:

  • Hepatic support is crucial for acute liver failure (ALF) patients, either to promote liver regeneration or as a bridge to orthotopic liver transplantation (OLT).
  • Bioartificial liver (BAL) devices aim to replicate the liver's metabolic and biotransformation functions using hepatocytes.

Purpose of the Study:

  • To define the essential criteria for cellular components and cell mass in bioartificial liver (BAL) development.
  • To guide the selection of hepatocytes and determine the required cell quantity for effective BAL therapy.

Main Methods:

  • Review of existing knowledge on hepatocyte function and BAL device requirements.
  • Analysis of cell viability and functional capacity based on cell source (primary, cultured, engineered, animal).

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Main Results:

  • Primary hepatocytes are preferred due to their high differentiation and function.
  • A minimum cell mass of 150 grams (10% of adult liver) of viable hepatocytes is recommended for BAL.
  • Increased cell mass is necessary for cold-stored or cryopreserved hepatocytes to compensate for reduced viability and function.

Conclusions:

  • The selection of appropriate hepatocytes and ensuring adequate functional cell mass are paramount for successful BAL therapy.
  • While hepatoma-derived, cultured, or engineered cells can be used, their functional capacity must match primary hepatocytes.
  • The use of animal hepatocytes in BAL is currently limited to bridging ALF patients to OLT due to zoonotic disease risks.