Hepatic tissue engineering for adjunct and temporary liver support: critical technologies.
The severe donor liver shortage, high cost, and complexity of orthotopic liver transplantation have prompted the search for alternative treatment strategies for end-stage liver disease, which would require less donor material, be cheaper, and less invasive. Hepatic tissue engineering encompasses several approaches to develop adjunct internal liver support methods, such as hepatocyte transplantation and implantable hepatocyte-based devices, as well as temporary extracorporeal liver support techniques, such as bioartificial liver assist devices. Many tissue engineered liver support systems have passed the "proof of principle" test in preclinical and clinical studies; however, they have not yet been found sufficiently reliably effective for routine clinical use. In this review we describe, from an engineering perspective, the progress and remaining challenges that must be resolved in order to develop the next generation of implantable and extracorporeal devices for adjunct or temporary liver assist.
Chan
Christina
C
Center for Engineering in Medicine/Surgical Services, Massachusetts General Hospital, Harvard Medical School, and the Shriners Hospitals for Children, Boston, MA 02114, USA.
Berthiaume
François
F
Nath
Bharath D
BD
Tilles
Arno W
AW
Toner
Mehmet
M
Yarmush
Martin L
ML
D020811:Biomedical Technology; D022781:Hepatocytes; D006801:Humans; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation; D019164:Liver, Artificial; D019736:Prostheses and Implants; D023822:Tissue Engineering