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Decellularization and Recellularization of Whole Livers
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Artificial and bioartificial liver devices: present and future.

B Carpentier1, A Gautier, C Legallais

  • 1UTC, UMR CNRS 6600 Biomechanics and Bioengineering, BP 20529, 60205 Compiègne Cedex, France.

Gut
|November 20, 2009
PubMed
Summary
This summary is machine-generated.

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Temporary artificial and bioartificial liver devices offer support for liver failure. While artificial systems lack proven clinical benefits, bioartificial systems show promise but face challenges like cost and cell viability for widespread use.

Area of Science:

  • Hepatology
  • Biomedical Engineering
  • Regenerative Medicine

Background:

  • Liver failure presents significant morbidity and mortality risks.
  • Temporary support devices, including artificial livers (ALs) and bioartificial livers (BALs), are crucial for managing liver failure.
  • ALs utilize non-living components for toxin removal, while BALs employ hepatocytes within bioreactors for biotransformation and synthetic functions.

Purpose of the Study:

  • To review the operating principles, chemical and clinical effects, and complications of ALs and BALs.
  • To provide specific attention to the advancements and challenges associated with bioartificial liver systems.
  • To assess the current status and future potential of these temporary liver support technologies.

Main Methods:

  • Comprehensive literature review of artificial and bioartificial liver support systems.

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  • Analysis of operating principles, efficacy, and safety data.
  • Examination of clinical trial outcomes and regulatory approvals.

    • Main Results:

    • Several artificial liver support systems have received regulatory approval (FDA, CE marking), but their clinical impact remains undemonstrated.
    • Bioartificial liver systems are under clinical investigation, showing potential to replace multiple liver functions.
    • Significant hurdles for BALs include cost, cell availability, maintaining cell viability, regulatory challenges, and bedside implementation.

    Conclusions:

    • Artificial liver devices have limited demonstrated clinical benefit despite regulatory approval.
    • Bioartificial liver systems hold promise for liver failure treatment but require further development to overcome practical and regulatory challenges.
    • The combination of bioreactors with artificial components represents a pragmatic future direction for liver failure management.