Bioartificial Liver Reduces Liver-Failure Deaths

and European centers has found that a bioartificial liver reduced mortality of patients suffering from acute liver failure by 44%. The results were published in the May 2000 issue of Annals of Surgery.

Standard treatment for patients with acute liver failure currently consists of intensive, supportive care intended to keep patients alive long enough so that the liver may recover spontaneously or a donor organ may become available for transplantation.

During treatment with the bioartificial liver, blood is drawn from a vein through a catheter. Blood plasma is separated from the serum and pumped through a charcoal column and an oxygenator before it reaches the bioreactor, a tube-shaped device containing a fiber membrane and seven billion liver cells from pigs. These cells are isolated, cryopreserved, and thawed according to techniques originally developed by researchers at Cedars-Sinai Medical Center (Los Angeles, CA, USA).

"Just before the patient is treated, the pig liver cells are thawed, reactivated, and attached to small beads that serve as a scaffold for the cells. We put the cells and beads into the cartridge, and when the patient's plasma flows through the fibers, the pig liver cells detoxify it and replace missing nutrients,” explained principal investigator Achilles A. Demetriou, M.D., Ph.D., chairman of surgery at Cedars-Sinai, who helped to develop the artificial liver.

Each treatment is completed in about six hours, and the benefits last about 24 hours. In most cases of acute liver failure, a series of treatments may need to continue for only a few days or for several weeks. In the study, the results of only the 147 patients with fulminant/subfulminant hepatic failure showed that the liver device, called BAL, provided a 44% reduction in mortality.




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