title: New Strategies for Acute Liver Failure: Focus on Xenotransplantation Therapy.
abstract: Acute liver failure (ALF) has a poor prognosis and, despite intensive care support, reported average survival is only 10-40%. The most common causes responsible for ALF are viral hepatitis (mainly hepatitis A and B) and acetaminophen poisoning. Hepatic transplantation is the only appropriate treatment for patients with unlikely survival with supportive care alone. Survival rates after transplantation can be as high as 80-90% at the end of the first year. However, there is a shortage of donors and is not uncommon that no appropriate donor matches with the patient in time to avoid death. Therefore, new technologies are in constant development, including blood purification therapies as plasmapheresis, hemodiafiltration, and bioartificial liver support. However, they are still of limited efficacy or at an experimental level, and new strategies are welcome. Accordingly, cell transplantation has been developed to serve as a possible bridge to spontaneous recovery or liver transplantation. Xenotransplant of adult hepatocytes offers an interesting alternative. Moreover, the development of transgenic pigs with less immunogenic cells associated with new immunosuppressor strategies has allowed the development of this area. This article reviews some of the newly developed techniques, with focus on xenotransplant of adult hepatocytes, which might have clinical benefits as future treatment for ALF.
authors.affiliation: Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: Luiz Anastácio
authors.initials: LA
authors.lastname: Alves
authors.affiliation: Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Bonavita
authors.affiliation: Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: Kátia
authors.initials: K
authors.lastname: Quaresma
authors.affiliation: Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: Elenilde
authors.initials: E
authors.lastname: Torres
authors.affiliation: Laboratório de Comunicação Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: Paulo Anastácio Furtado
authors.initials: PA
authors.lastname: Pacheco
authors.affiliation: † Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: Vinícius
authors.initials: V
authors.lastname: Cotta-de-Almeida
authors.affiliation: ‡ Instituto de Pesquisa Evandro Chagas (IPEC), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz , Rio de Janeiro , Brazil.
authors.forename: Roberto Magalhães
authors.initials: RM
authors.lastname: Saraiva
keywords: Acute liver failure; Cell therapy; Survival; Xenotransplantation