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Extracorporeal liver support. Application to fulminant hepatic failure
N L Sussman1, G T Gislason, J H Kelly
1Department of Medicine, Baylor College of Medicine, Houston, Texas.
Journal of Clinical Gastroenterology
|June 1, 1994
Summary
Artificial liver support devices are crucial for end-stage liver disease and fulminant hepatic failure (FHF). Biologically active devices offer a promising alternative to liver transplantation, potentially enabling liver regeneration.
Area of Science:
- Biomedical Engineering
- Hepatology
- Regenerative Medicine
Background:
- End-stage liver disease necessitates advanced support systems.
- Current mechanical devices fail to address metabolic derangements.
- Biologically active artificial liver devices are limited by cell viability and availability.
Purpose of the Study:
- To review the theoretical and practical aspects of biologically active artificial liver support devices.
- To address the unmet need for effective treatments for fulminant hepatic failure (FHF).
- To evaluate artificial liver devices as an alternative to orthotopic liver transplantation (OLT).
Main Methods:
- Review of existing literature on artificial liver support systems.
- Analysis of challenges in culturing and maintaining viable liver cells for bio-artificial devices.
- Examination of FHF as a model for evaluating liver support technologies.
Main Results:
- Mechanical devices like hemodialysis do not correct metabolic abnormalities in liver failure.
- Orthotopic liver transplantation (OLT) is effective but carries significant risks and lifelong management.
- Successful artificial liver support could stabilize patients and potentially allow for liver regeneration, avoiding transplantation.
Conclusions:
- Artificial liver support is a critical area of medical research.
- Biologically active devices hold promise for managing acute liver failure.
- Further development is needed to overcome limitations in cell-based therapies for liver regeneration.