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Reversal of fulminant hepatic failure using an extracorporeal liver assist device
Author(s) -
Sussman Norman L.,
Chong Maria G.,
Koussayer Tarek,
He DaEr,
Shang Thomas A.,
Whisennand Hartwell H.,
Kelly James H.
Publication year - 1992
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840160112
Subject(s) - fulminant hepatic failure , bioartificial liver device , liver transplantation , liver function , medicine , extracorporeal , liver disease , liver injury , albumin , liver function tests , transplantation , gastroenterology , biology , hepatocyte , biochemistry , in vitro
Liver transplantation is currently the only effective therapy for patients with fulminant hepatic failure. The availability of an artificial liver could bridge these patients through the relatively brief crisis period and allow their own livers to regenerate, providing a more favorable outcome and sparing the trauma and expense of transplant. We have developed a device consisting of a highly differentiated human liver cell line cultured in a hollow fiber cartridge. This device is capable of supporting dogs with acetaminopheninduced fulminant hepatic failure for a period long enough for their own livers to resume function. Even though liver function tests such as albumin and prothrombin time became extremely abnormal during the course of the experiment, the dogs did not become encephalopathic. Two of the three treated animals recovered sufficient liver function after 42 to 48 hr of treatment that they could be disconnected from the device, and they survived the experiment. Histological results and serum ALT levels suggest that the device affected the course of the disease in two animals, allowing recovery of hepatocytes that would otherwise have lysed. In the third animal, regenerative nodules demonstrated that, even in the presence of severe liver injury, the device was capable of supporting total liver function. (H EPATOLOGY 1992;16:60–65.)