Early Experiences with a Porcine Hepatocyte-based Bioartificial Liver in Acute Hepatic Failure Patients

@article{Morsiani2002EarlyEW,
  title={Early Experiences with a Porcine Hepatocyte-based Bioartificial Liver in Acute Hepatic Failure Patients},
  author={Eugenio Morsiani and Paolo Pazzi and A. C. Puviani and M. Brogli and L. Valieri and Paolo Gorini and P Scoletta and Egidio Marangoni and Riccardo Ragazzi and Gianfranco Azzena and Emilio Frazzoli and Dario Di Luca and Enzo Cassai and Guido Lombardi and Antonino Cavallari and Stefano Faenza and Alberto Pasetto and Massimo Girardis and Elio Jovine and Antonio Daniele Pinna},
  journal={The International Journal of Artificial Organs},
  year={2002},
  volume={25},
  pages={192 - 202}
}
Orthotopic liver transplantation (OLT) is the only effective therapeutic modality in severe acute hepatic failure (AHF). The scarcity of organs for transplantation leads to an urgent necessity for temporary liver support treatments in AHF patients. A hepatocyte-based bioartificial liver (BAL) is under investigation with the main purpose to serve as bridging treatment until a liver becomes available for OLT, or to promote spontaneous liver regeneration. We developed a novel radial-flow… 
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TLDR
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TLDR
Critical issues for the development of BAL such as bioreactor configuration, mass transfer, cell source and culture technique, and the characteristics of membrane BAL systems in clinical, preclinical and in vitro tests are reviewed.
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Liver support systems are safe and well tolerated when used in management of patients with ACLF and should continue in controlled clinical trials to explore their role in bridging patients to liver transplantation or recovery in well defined patient groups.
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References

SHOWING 1-10 OF 31 REFERENCES
Early clinical experience with a hybrid bioartificial liver.
TLDR
BAL treatment is safe and beneficial and can be successfully used as a 'bridge' to transplantation.
Isolated hepatocytes in a bioartificial liver: A single group view and experience
TLDR
The authors conclude that BAL treatment with porcine hepatocytes appears to be safe and can help maintain patients alive and neurologically intact until a liver becomes available for transplantation.
A Bioartificial Liver to Treat Severe Acute Liver Failure
TLDR
The bioartificial liver developed by the authors is safe and serves as an effective “bridge” to liver transplant in some patients and in vivo in experimental animals with liver failure.
Clinical experience with a bioartificial liver in the treatment of severe liver failure. A phase I clinical trial.
TLDR
A bioartificial liver to treat patients with severe liver failure until they can be either transplanted or recover spontaneously and the authors' clinical experience with the BAL has yielded encouraging results.
Bioartificial liver treatment prolongs survival and lowers intracranial pressure in pigs with fulminant hepatic failure.
TLDR
Examination of whether BAL therapy alone could prevent development of intracranial hypertension in pigs with surgically induced FHF found that Group 1 pigs maintained a normal ICP during BAL treatment and for 14 h afterward and because of this effect they survived longer than Groups 2 and 3 animals.
Pilot‐controlled trial of the extracorporeal liver assist device in acute liver failure
TLDR
Assessment of additive function for the device revealed an improvement in galactose elimination capacity after 6 hours of haemoperfusion, and better indices of prognosis will be required, in addition to those used to select for transplantation, if patients at an earlier stage of clinical deterioration are to be included in future studies.
Optimization of rat hepatocyte culture in citrated human plasma.
TLDR
Appropriate metabolic and hormonal supplementation of citrated human plasma prevents its cytotoxic effects and may be used in conjunction with in vivo use of bioartificial liver assist systems.
Characterization of human xenoreactive antibodies in liver failure patients exposed to pig hepatocytes after bioartificial liver treatment: an ex vivo model of pig to human xenotransplantation.
TLDR
Repetitive exposure of humans to porcine antigens after BAL treatment, results in a strong IgG and IgM XAb responses that are primarily directed against the alphaGal epitope.
In vitro morphological and functional characterization of isolated porcine hepatocytes for extracorporeal liver support: bile acid uptake and conjugation.
TLDR
The data demonstrate the ability of BAL to clear bile acids from the circulation, to accumulate cholate and taurocholate, and to conjugate a substantial amount of cholic acid.
Extracorporeal plasma perfusion of cultured hepatocytes: effect of intermittent perfusion on hepatocyte function and morphology.
TLDR
Results suggest that cultured hepatocytes may be exposed to plasma for at least 20 hr with no significant reduction in liver-specific function and an intermittent plasma perfusion schedule can be used to divide the useful plasma perfusions time over several days with no adverse effects on cell function.
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