Cellular therapy and bioartificial approaches to liver replacement

Area of Science:

• Hepatology and Transplant Surgery
• Regenerative Medicine
• Immunology

Background:

• Liver transplantation success has improved, yet a critical donor organ shortage persists, leading to high waitlist mortality.
• The demand for liver transplants significantly outstrips the available donor organs, creating a substantial unmet clinical need.

Purpose of the Study:

• To review current and emerging alternative liver replacement strategies beyond traditional transplantation.
• To discuss the potential and limitations of xenotransplantation, organ engineering, and cell-based therapies for liver failure.

Main Methods:

• Review of recent advancements in liver replacement technologies.
• Analysis of preclinical data from small and large animal studies.

Main Results:

• Early extracorporeal liver perfusion devices showed safety but lacked clinical efficacy.
• Current research focuses on xenotransplantation, engineered organs, and cell transplantation, with ongoing studies in animal models.

Conclusions:

• Novel sources of organs or cells are essential for long-term solutions to liver failure.
• Recent progress in xenotransplantation, tissue engineering, and cell therapy offers hope, despite existing challenges.
• Addressing identified challenges in these alternative therapies may pave the way for definitive treatment for all patients needing liver replacement.