Overview of Extracorporeal Liver Support Systems and Clinical Results

McLAUGHLIN, Brian E.; Tosone, Christine M; Custer, Linda; Mullon, Claudy

doi:10.1111/j.1749-6632.1999.tb08514.x

Cited by 60 publications

(19 citation statements)

References 55 publications

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“…Significant progress has been made in developing bioartificial liver systems. Various aspects can be found in some excellent reviews (Kamohara et al 1998, Jauregui 1999, McLaughlin et al 1999, Allen et al 2001,Millis et al 2002, Strain & Neuberger 2002.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Cell Viability with Pulsating Flow in a Hollow Fiber Bioartificial Liver

2005

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A pulsating flow of medium was used to alleviate diffusion and transport limitations in a hollow fiber bioreactor containing a human hepatoblastoma cell line. The strategy is easy to implement but effective. The pulsating flow is introduced by a solenoid pinch valve at the outlet of the bioreactor and regulated by a timing circuit. In a permeability test, the system with pulsating flow had much less membrane fouling as compared to the control, a conventional hollow fiber unit. In hepatocyte culture test runs, the pulsating-flow bioreactor demonstrated the ability to maintain a higher cell viability. Histological sections indicated significantly smaller necrotic regions in the pulsating-flow bioreactor as compared to the conventional unit.

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Section: Introductionmentioning

confidence: 99%

Enhancing Cell Viability with Pulsating Flow in a Hollow Fiber Bioartificial Liver

2005

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“…Acute liver failure (ALF) is a clinically incurable and fatal disease [1] . Currently, orthotopic liver transplantation (OLT) is the most effective method in the treatment of ALF [2] .…”

Section: Introductionmentioning

confidence: 99%

Preliminary characteristic of alginate, heparin-chitosan-alginate, heparin microencapsulated hepatocytes system

Shan-xin

Han

Cui

et al. 2012

J. Shanghai Jiaotong Univ. (Sci.)

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Preliminary Characteristic of Alginate, Heparin-Chitosan-Alginate, Heparin Microencapsulated Hepatocytes SystemAlginate, low mole mass heparin-chitosan-alginate, low mole mass heparin microcapsules (ALCAL) with good mechanical stability were made from the high voltage pulsing microcapsule shaping device. ALCAL was made of low-mole-mass heparin (LMWH), alginate (ALG) and chitosan (CS) by supramolecular layer upon layer self-assembled technique. It was found from the microscopic observation that the microcapsules had smooth surface and a porous structure with interconnected pores. The results of the permeability experiment of microcapsules using fluorescein isothiocyanate-bovine serum albumin (FITC-BSA) and fluorescein isothiocyanate-immunoglobulin G (FITC-IgG) showed that the ALCAL membrane could provide cell immuno-isolation; meanwhile, the ALCAL membrane had good biocompatibility. The potential of ALCAL microcapsules for the encapsulation of liver cells had been investigated and showed that the ALCAL membrane supports the survival, proliferation and protein secretion on encapsulating hepatocytes. The ALCAL microcapsule had several advantages compared to more widely used alginate-chitosan-alginate (ACA) microcapsules for the application of cell therapy.

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“…In order to circumvent this problem, alternative methods have been developed to stabilize the conditions of patients with hepatic failure until the regeneration of the liver or availability of the donor organ (Rifai et al 2003). Several extracorporeal detoxification systems, such as hemodialysis, hemofiltration, adsorption, plasma exchange, and plasma perfusion, to support liver functions have been clinically tested with varying success (McLaughlin et al 1999). Since the liver commands a myriad of functions, including hormonal regulation, biotransformation and detoxification, protein synthesis, lipid and glucose metabolism, production of bile components, as well as pH regulation (Kmiec´2001), complex biochemical pathways exist that cannot be simply replaced by these non-biological liver support systems.…”

Section: Introductionmentioning

confidence: 99%

Present and Future Developments in Hepatic Tissue Engineering for Liver Support Systems

Diekmann¹,

Bader

Schmitmeier

2006

Cytotechnology

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The liver is the most important organ for the biotransformation of xenobiotics, and the failure to treat acute or acute-on-chronic liver failure causes high mortality rates in affected patients. Due to the lack of donor livers and the limited possibility of the clinical management there has been growing interest in the development of extracorporeal liver support systems as a bridge to liver transplantation or to support recovery during hepatic failure. Earlier attempts to provide liver support comprised non-biological therapies based on the use of conventional detoxification procedures, such as filtration and dialysis. These techniques, however, failed to meet the expected efficacy in terms of the overall survival rate due to the inadequate support of several essential liver-specific functions. For this reason, several bioartificial liver support systems using isolated viable hepatocytes have been constructed to improve the outcome of treatment for patients with fulminant liver failure by delivering essential hepatic functions. However, controlled trials (phase I/II) with these systems have shown no significant survival benefits despite the systems' contribution to improvements in clinical and biochemical parameters. For the development of improved liver support systems, critical issues, such as the cell source and culture conditions for the longterm maintenance of liver-specific functions in vitro, are reviewed in this article. We also discuss aspects concerning the performance, biotolerance and logistics of the selected bioartificial liver support systems that have been or are currently being preclinically and clinically evaluated.

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Overview of Extracorporeal Liver Support Systems and Clinical Results

Cited by 60 publications

References 55 publications

Enhancing Cell Viability with Pulsating Flow in a Hollow Fiber Bioartificial Liver

Enhancing Cell Viability with Pulsating Flow in a Hollow Fiber Bioartificial Liver

Preliminary characteristic of alginate, heparin-chitosan-alginate, heparin microencapsulated hepatocytes system

Present and Future Developments in Hepatic Tissue Engineering for Liver Support Systems

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