A biodialysis system for liver support tested in a porcine hepatic failure model.
BACKGROUND
A practical liver support system for patients in fulminant hepatic failure (FHF) remains a needed therapeutic modality. A new method of bioartificial liver support, the liver biodialysis system (LBDS), is described.


METHODS
Porcine hepatocytes, removed from direct contact with the treated subject's circulation, are in culture in a bioreactor which is combined in a dialysis circuit for patient treatment. The LBDS was tested in a porcine ischaemic hepatic failure model.


RESULTS
The viable hepatocyte content of the bioreactor was 2.49 +/- 0.72 x 10(10). Cells remained viable in culture throughout the experiments (30 +/- 3 h) without evidence of immunological damage. A decrease in the degree of accumulation in the blood of ammonia (P < 0.02) and of 14 amino acids (P < 0.001) was achieved by the LBDS. Cerebral perfusion pressure was maintained at significantly higher levels in LBDS-treated animals (P < 0.05).


CONCLUSIONS
In the LBDS, hepatocytes in large numbers and satisfactory culture conditions in a bioreactor have sustained viability and function. When combined in a dialysis circuit for the treatment of FHF pigs, immune reactions between the blood and hepatocytes were prevented and beneficial metabolic effects were observed.
Sheil
A G
AG
Department of Surgery, University of Sydney, New South Wales, Australia. agrs@liver.rpa.cs.nsw.gov.au
Sun
J
J
Wang
L
L
Rao
N
N
Mears
D C
DC
Wang
C
C
Woodman
K
K
Johnston
B
B
Watson
J
J
D000596:Amino Acids / Q000097:blood; D000818:Animals; D003956:Dialysis / Q000295:instrumentation* / Q000379:methods; D004195:Disease Models, Animal; D004867:Equipment Design; D008099:Liver / Q000166:cytology; D017093:Liver Failure / Q000628:therapy*; D019164:Liver, Artificial; D013552:Swine
D000596:Amino Acids