Hepatic assist devices: will they ever be successful?

Area of Science:

• Biomedical Engineering
• Hepatology
• Regenerative Medicine

Background:

• Hepatic assist technologies, including artificial and bioartificial livers, have not yet achieved clinical success.
• Current artificial livers using sorbents and membranes offer temporary support for acute decompensation but not true liver support.
• Bioartificial livers (BALs) combining liver cells with synthetic devices show promise but face challenges in clinical application.

Purpose of the Study:

• To propose achievable goals for developing a clinically viable bioartificial liver (BAL).
• To highlight the importance of systems biology approaches in BAL design.
• To identify potential sources of hepatocytes for BAL construction.

Main Methods:

• Review and synthesis of current challenges in hepatic assist technology.
• Conceptual framework development for BAL design incorporating systems biology principles.
• Exploration of alternative hepatocyte sources for improved BAL function.

Main Results:

• Current artificial liver devices are limited to temporary support, not full liver replacement.
• Significant advancements are needed to translate promising BAL concepts into clinical reality.
• Systems biology and novel cell sourcing are key to future BAL development.

Conclusions:

• True hepatic support necessitates the development of functional bioartificial livers (BALs).
• Achieving a clinically useful BAL requires a multidisciplinary approach, integrating systems biology and advanced cell sourcing strategies.
• Future research should focus on overcoming the technical and biological hurdles to BAL implementation.