Current and prospective therapies for acute liver failure

Evolving Cell-Based and Cell-Free Clinical Strategies for Treating Severe Human Liver Diseases

“…The increase in the number of patients awaiting LT and the inability of support systems to restore liver function have led to the advent of extracorporeal bioartificial liver (BAL) devices [2]. BAL devices are support systems for liver function, which perform detoxification and synthesis, for instance, and are connected to the patient's venous circulation with the possibility of plasma separation (Figure 3).…”

“…In this system, the cells grow inside the extracapillary space of a cartridge while the patient's plasma flows inside the lumen of the hollow fibers. The latter, made with a semi-permeable membrane, allow the passage of the patient's ultrafiltrate to C3A cells while allowing the exchange of toxins and nutrients [2]. Another BAL support system, HepatAssist, employs pig hepatocytes within an extracapillary compartment of a hollow fiber bioreactor [2].…”

“…The latter, made with a semi-permeable membrane, allow the passage of the patient's ultrafiltrate to C3A cells while allowing the exchange of toxins and nutrients [2]. Another BAL support system, HepatAssist, employs pig hepatocytes within an extracapillary compartment of a hollow fiber bioreactor [2]. Despite the wide availability of porcine hepatocytes, these cells raise some concerns in terms of xenotransplantation in humans, due to the possibility of xenozoonosis [88].…”

“…Cirrhosis and hepatocellular carcinoma cause approximately 2 million deaths per year, placing liver disorders among the top 20 most common causes of death worldwide [1]. Chronic exposure to excessive and prolonged use of alcohol, viral infections, metabolic disorders, toxins, non-alcoholic fatty liver and cancer are among the common causes of liver cirrhosis [2]. Advanced cirrhosis is generally considered irreversible, unlike its preceding steps (hepatitis and fibrosis), even when the causal agent is removed [3].…”

Silencing long noncoding RNA NEAT1 alleviates acute liver failure via the EZH2-mediated microRNA-139/PUMA axis

“…Ever since the advent of emergency of liver transplantation, the overall survival rate of ALF has increased to about 70% and the 2-year survival rate reaches 92.4% [ 2 ]. Aside from liver transplantation, currently available treatment modalities for ALF include hepatocyte transplantation, extracorporeal liver support devices, molecular adsorbent recirculating system, plasmapheresis and bioartificial liver support systems [ 3 ]. Key features of ALF include a systemic inflammatory response, abnormal coagulation, and upregulation of aminotransferases activity including Alanine aminotransferase (ALT) and Aspartate transaminase (AST) [ 4 ].…”