title: Experimental evaluation of a cell module for hybrid liver support.
abstract: Aim of the study was to evaluate a hybrid liver support system in a porcine model of acute liver failure, after hepatectomy. Pigs with a body weight of 70+/-18 kg underwent total hepatectomy and porto-cavo-caval shunting as well as ligation of the bile duct and the hepatic artery. Control animals were connected to the system (including capillary membrane plasma separation) containing a four compartment bioreactor with integral oxygenation and decentralized mass exchange but without liver cells. The treatment group received hybrid liver support with the same system including 370+/-42 g primary isolated porcine parenchymal liver cells in co-culture with hepatocyte nursing cells, tissue engineered to liver- like structures at high density. Treatment started after complete recovery from anesthesia and was performed continuously. A positive influence on peripheral vascular resistance and a reduced need of catecholamine dosage was observed in the treatment group. Hybrid liver support with a cell module upscaled for clinical application significantly prolonged survival time in animals after hepatectomy with the longest survival being 26 hours in the control group an 57 hours in the treatment group.
authors.affiliation: Clinic for Surgery, Humboldt University of Berlin, Germany. joerg.gerlach@charite.de
authors.forename: J C
authors.initials: JC
authors.lastname: Gerlach
authors.forename: M
authors.initials: M
authors.lastname: Botsch
authors.forename: D
authors.initials: D
authors.lastname: Kardassis
authors.forename: P
authors.initials: P
authors.lastname: Lemmens
authors.forename: M
authors.initials: M
authors.lastname: Schön
authors.forename: J
authors.initials: J
authors.lastname: Janke
authors.forename: G
authors.initials: G
authors.lastname: Puhl
authors.forename: J
authors.initials: J
authors.lastname: Unger
authors.forename: M
authors.initials: M
authors.lastname: Kraemer
authors.forename: B
authors.initials: B
authors.lastname: Busse
authors.forename: C
authors.initials: C
authors.lastname: Böhmer
authors.forename: R
authors.initials: R
authors.lastname: Belal
authors.forename: M
authors.initials: M
authors.lastname: Ingenlath
authors.forename: M
authors.initials: M
authors.lastname: Kosan
authors.forename: B
authors.initials: B
authors.lastname: Kosan
authors.forename: J
authors.initials: J
authors.lastname: Sültmann
authors.forename: A
authors.initials: A
authors.lastname: Patzold
authors.forename: S
authors.initials: S
authors.lastname: Tietze
authors.forename: R
authors.initials: R
authors.lastname: Rossaint
authors.forename: C
authors.initials: C
authors.lastname: Müller
authors.forename: E
authors.initials: E
authors.lastname: Mönch
authors.forename: I M
authors.initials: IM
authors.lastname: Sauer
authors.forename: P
authors.initials: P
authors.lastname: Neuhaus
mesh_terms: D000818:Animals; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D066298:In Vitro Techniques; D017114:Liver Failure, Acute / Q000209:etiology / Q000628:therapy*; D019164:Liver, Artificial; D023421:Models, Animal; D016019:Survival Analysis; D013552:Swine