Biological Assist Devices in Fulminant Hepatic Failure(Workshop1-12)

概要

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Since the liver is primarily a metabolic organ, an artificial liver will only be successful if it replaces the biochemical functions which have been lost in the course of liver failure. This explains the success of liver transplantation and the failure of non-biological support systems. We have developed an extracorporeal liver assist device (ELAD) based on an immortalized human hepatocyte cell line. The cells (C3A) express complex liver-specific functions such as gluconeogenesis, ureagenesis, and P450 activity, and they grow to high density in a standard dialysis cartridge. Each cartridge provides the metabolic function of about 20% of an adult liver, and two in series provide 40%. The validity of this approach was shown in a canine model of acute liver failure, and subsequently adapted to human use. Metabolic testing confirms that the devices provide substantial liver function during treatment. A rigorous trial is needed to prove that treatment with the ELAD improves the outcome of acute liver failure.
日本アフェレシス学会の論文