Reversal of fulminant hepatic failure using an extracorporeal liver assist device

@article{Sussman1992ReversalOF,
  title={Reversal of fulminant hepatic failure using an extracorporeal liver assist device},
  author={Norman Leslie Sussman and M. G. Chong and T Koussayer and D E He and Tao Shang and H H Whisennand and James H. Kelly},
  journal={Hepatology},
  year={1992},
  volume={16}
}
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… 
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TLDR
A flat-plate BAL with an internal membrane oxygenator and cultured porcine hepatocytes has yielded encouraging results in the treatment of rats with GalN-induced FHF.
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TLDR
Past experience with biological liver-assist devices is reviewed, the field's present status is examined, and the author's own experience with a hepatocyte-based bioartificial liver is summarized.
Liver replacement therapy.
The realization of a support device able to effectively replace liver function in patients with hepatic failure has thus far been an elusive goal. The complexity of liver metabolic, synthetic,
Cell-based therapy of acute liver failure: The extracorporeal bioartificial liver
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A reliable extracorporeal hybrid bioartificial liver based on alginate bead-entrapped hepatocytes was used successfully for the correction of the Gunn rat genetic defect, which results in lack of bilirubin conjugation.
Development and testing of a bioartificial liver.
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It appears that, at least for now, whole organ transplantation remains the only method with clinically-proven efficacy for treating severe acute liver failure.
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References

SHOWING 1-10 OF 13 REFERENCES
Assessment of an extracorporeal liver assist device in anhepatic dogs.
TLDR
An anhepatic dog model is used to demonstrate the efficacy of a bioartificial liver assist device capable of replacing the metabolic function of the liver, and might provide hepatic support in patients awaiting transplantation or in fulminant hepatic failure.
Fulminant hepatic failure and the need for artificial liver support.
  • S. Pappas
  • Medicine
    Mayo Clinic proceedings
  • 1988
TLDR
The observation that many patients with FH F now die of complications of increased intracranial pressure (ICP), which accounted for 9 of the 14 deaths recently observed at this institution, makes it imperative that patients withfulminant hepatic failure be carefully monitored for signs of increased ICP and that appropriate therapy be instituted.
An improved model of acetaminophen‐induced fulminant hepatic failure in dogs
TLDR
An improved model of fulminant hepatic failure in dogs is established, using Buthionine sulfoximine to inactivate glutathione synthesis, and small increments of acetaminophen given intravenously to maintain the plasma level at approximately 200 μg/ml for 20 hr.
Postdilution hemofiltration in the management of acute hepatic failure: a pilot study.
TLDR
A possible role for PDHF as a temporary artificial liver support system for patients with acute hepatic failure is supported and a close temporal relationship was noted between the improvement and the procedure.
Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure.
TLDR
There was in both trials a significant relationship between survival and etiology quite independent of the use or duration of hemoperfusion, except in the non-A, non-B hepatitis and halothane or drug reaction subgroups, which had a high mortality throughout.
Liver transplantation.
  • T. Starzl
  • Medicine
    The Johns Hopkins medical journal
  • 1978
TLDR
The outlook after transplantation appears to have greatly improved, and a one-year survival rate of 50% is projected, and improvements in intraoperative and postoperative management were made with particular reference to biliary tract drainage and to the use of microvascular techniques.
Hemodiafiltration treatment of deep hepatic coma by protein passing membrane: case report.
TLDR
Although a large-scale controlled trial is needed, PMMA HDF is believed to be promising as a future artificial liver support, and resulted in complete recovery of deep coma and long-term survival in a patient with severe FHF.
Hybrid bioartificial liver in hepatic failure: preliminary clinical report.
TLDR
A hybrid bioartificial liver has been developed on the principle of hemodialysis against a suspension of functioning hepatocytes and was used successfully to treat a patient in hepatic failure due to an inoperable bile duct carcinoma that involved the bifurcation of the common duct.
A hybrid bioartificial liver composed of multiplated hepatocyte monolayers.
TLDR
A new hybrid artificial liver containing hepatocyte monolayers that may be a pilot design for the complete artificial liver was manufactured and evaluated and showed good function when compared with suspended cells.
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