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Clinical application of bioartificial liver support systems
Maarten Paul van de Kerkhove1, Ruurdtje Hoekstra, Robert A F M Chamuleau
1Department of Surgery (Surgical Laboratory), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Annals of Surgery
|July 27, 2004
Summary
Bioartificial liver (BAL) devices show promise for acute liver failure (ALF) patients awaiting transplantation. While safe, current BAL systems require further development and controlled trials to demonstrate significant survival benefits.
Area of Science:
- Hepatology
- Biomedical Engineering
- Regenerative Medicine
Background:
- Acute liver failure (ALF) presents a high mortality rate, with liver transplantation being the primary treatment.
- Organ donor shortages limit transplantation, leading to increased ALF patient mortality.
- Bioartificial liver (BAL) devices offer a promising alternative therapy to support ALF patients.
Purpose of the Study:
- To review the current status and clinical outcomes of bioartificial liver (BAL) devices.
- To assess the safety and efficacy of various BAL systems used in clinical trials.
Main Methods:
- A literature review was conducted using MEDLINE and other databases.
- Included studies focused on BAL systems that had undergone clinical trials.
- Eleven distinct BAL systems with clinical applications were identified.
Main Results:
- Eleven BAL systems have been clinically applied; three were in controlled trials without significant survival benefits due to small patient numbers.
- Other systems demonstrated safety in phase I trials or single-patient treatments.
- Most BAL therapies led to improvements in clinical and biochemical parameters.
Conclusions:
- Bioartificial liver therapy holds promise for bridging patients with ALF to transplantation or regeneration.
- Further advancements in BAL device technology, use of human hepatocytes, and controlled clinical trials are necessary to establish clinical value.