Bridges to transplantation

Area of Science:

• Hepatology
• Transplantation Medicine
• Critical Care

Background:

• Acute liver failure (ALF) necessitates liver transplantation.
• Organ Procurement and Transplantation Network (OPTN) status 1 patients have priority, but median wait times were 11 days in 2002.
• Small patients or those with rare blood types face extended waiting periods.

Purpose of the Study:

• To review the challenges in liver transplantation for acute liver failure.
• To evaluate the efficacy of artificial hepatic support systems as a bridge to transplantation.

Main Methods:

• Review of existing literature on liver support systems.
• Analysis of patient waiting times and outcomes for liver transplantation.

Main Results:

• Significant waiting times exist for liver transplantation, particularly for certain patient demographics.
• Cerebral edema and mortality are critical concerns during the waiting period.
• Proposed artificial liver support systems have not yet demonstrated effectiveness in controlled trials for preventing cerebral edema.

Conclusions:

• There is a critical need for effective bridging strategies for acute liver failure patients awaiting transplantation.
• Current artificial hepatic support systems have not proven successful in delaying cerebral edema onset in controlled studies.