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A review of bioartificial liver development from an artificial organ engineering perspective

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Book cover The Hepatocyte Review

Abstract

Fulminant hepatic failure (FHF) and acute episodes in chronic liver failure are associated with high mortality [1–3]. Organ transplantation is the only treatment acknowledged to improve patient survival when compared with intensive care [4,5]. There is a shortage of donors worldwide [6–8] resulting in approximately 50% mortality amongst patients awaiting transplants [9]. Furthermore, OLT renders graft recipients dependent upon immunosuppression [10,11]. US hospital charges average $250,000 for liver transplants [12]. It was estimated that in the USA in 1996, there were approximately 1,700 emergency liver transplants with 1,000 patients dying while waiting for a transplant. A further 1,000 patients with FHF or sudden onset of acute liver failure (ALF) were either not listed for transplant or died before being listed [13].

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References

  1. O’Grady JG, Alexander GJM, Hayllar KM and Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989; 97: 439–445.

    PubMed  Google Scholar 

  2. Tygstrup N and Ranek L. Assessment of prognosis in fulminant hepatic failure. Sem Liv Dis 1986; 6: 129–137.

    Article  CAS  Google Scholar 

  3. Hughes RD, Wendon J, and Gimson AES. Acute liver failure. Gut 1991; Supplement: s86-s91.

    Google Scholar 

  4. Edmond JC, Aran PP, Whitington PF, Broelsch CE and Baker AL. Liver transplantation in the management of fulminant hepatic failure. Gastroenterology 1989; 96: 1583–1588.

    Google Scholar 

  5. Gerlach JC, Ziemer R and Neuhaus P. Fulminant liver failure: Relevance of extracorporeal hybrid liver support systems. Int J Artif Organs 1996; 19: 7–13.

    PubMed  CAS  Google Scholar 

  6. Bismuth H, Samuel D, Gugenheim J, Castaing D, Bernau J et al. Emergency liver transplantation for fulminant hepatitis. Ann Intern Med 1987; 143: 337–341.

    Article  Google Scholar 

  7. Iwatsuki S, Stieber AC, Marsh JW, Tzakis AG, Todo S et al. Liver transplantation for fulminant hepatic failure. Transplant Proc 1989; 21: 2431–2443.

    PubMed  CAS  Google Scholar 

  8. Vickers C, Neuberger J, Buckels J, McMaster P and Elias E. Transplantation of the liver in adults and children with fulminant hepatic failure. J Hepatol 1988; 7: 143–150.

    Article  PubMed  CAS  Google Scholar 

  9. Kamlot A, Rozga J, Watanabe FD and Demetriou AA. Review: Artificial liver support systems. Biotechnology and Bioengineering 1996; 50: 382–391.

    Article  PubMed  CAS  Google Scholar 

  10. Kalayoglu M, Stratta RJ, Hoffman RM and Belzer FO. Quadruple immunosuppresive therapy for liver transplantation. Transpl Proc 1988; 20: 524–528.

    CAS  Google Scholar 

  11. McDiarmid SV, Klintmalm GB and Busuttil RW. FK506 conversion for intractable rejection of the liver allograft. Transplant Int 1993; 6: 305–312.

    Article  CAS  Google Scholar 

  12. Sussman NL and Lake JR. Treatment of hepatic failure–1996: Current concepts and progress towards liver dialysis. Am J Kidney Dis 1996; 27: 605–621.

    Article  Google Scholar 

  13. Circe-Biomedical-Inc., Registration Statement under the Securities Act of 1933 (USA). Form S 1. Sec. File Number 333–29751. Document filed with Securities and Exchange Commission, Washington DC, 20549, USA. 1997, Circe Biomedical Inc., 1 Ledgemont Centre, 128 Spring Street, Lexington, MA, 02173, USA.

    Google Scholar 

  14. Hughes RD and Williams R. Use of bioartificial and artificial liver support devices. Sem Liv Dis 1996; 16: 435–444.

    Article  CAS  Google Scholar 

  15. Matsubara S, Okabe K, Ouchi K, Miyakazi Y, Yajima Yet al. Continuous removal of middle molecules by hemofiltration in patients with acute liver failure. Crit Care Med 1990; 18: 1331–1338.

    Article  PubMed  CAS  Google Scholar 

  16. Sarnatskaya VV, Nikolaev VG, Osipova LA, Ivanov AI, Maslenny VN et al. Peritoneal dialysis for the removal of protein-bound markers of hepatic insufficiency. Artificial Organs 1993; 17: 828–836.

    Article  PubMed  CAS  Google Scholar 

  17. Kondrup J, Almdal T, Vilstrup H and Tygstrup N. High volume plasma exchange in fulminant hepatic failure. Int J of Artific Org 1992; 15: 669–676.

    CAS  Google Scholar 

  18. Yoshiba M, Sekiyama K, Iwamura Y and Sugata F. Development of reliable artificial liver support (ALS)–plasma exchange in combination with hemodiafiltration using high performance membranes. Dig Dis Sei 1993; 38: 469–476.

    Article  CAS  Google Scholar 

  19. Chang TMS. Haemoperfusion Over microencapsulated adsorbent in a patient with hepatic coma. The Lancet 1973; ii: 1371–1372.

    Google Scholar 

  20. O’Grady, J, Gimson AES, O’Brien CJ, Pucknell A, Hughes RD et al. Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure. Gastroenterology 1988; 94: 1186–1192.

    PubMed  Google Scholar 

  21. Eiseman B, Liem DS and Raffucci F. Heterologous liver perfusion in treatment of hepatic failure. Ann Surg 1973; 162: 329–345.

    Article  Google Scholar 

  22. Schafer DF. Desperate Appliances: A short review of therapies for fulminant hepatic failure. Blood Purification 1993; 11: 158–162.

    Article  PubMed  CAS  Google Scholar 

  23. Gumucio JJ and Chianale J. Liver Cell Heterogeneity and Liver Function. In: Arias IM et el., Eds. The Liver: Biology and Pathobiology, Second Edition. Raven Press Ltd. New York. 1998: 931–947.

    Google Scholar 

  24. Sorrentino F. Prime richerche per la realizzatione di un fegato artificiale. Chir Patol Sper 1956; 4: 1401–1414.

    Google Scholar 

  25. Nose Y, Mikami J and Kasai Y. An experimental artificial liver utilizing extracorporeal metabolism with slices or granulated canine liver. Trans Am Soc Artif Intern Organs 1963; 9: 358–362.

    PubMed  CAS  Google Scholar 

  26. Wolf CFW and Munkelt BE. Bilirubin conjugation by an artificial liver composed of cultured cells and synthetic capillaries. Trans Amer Soc Artif Int Organs 1975; 21: 16–27.

    CAS  Google Scholar 

  27. Matsumura KN, Guevera GR, Huston H, Hamilton WL, Rikimaru M et al. Hybrid bioartificial liver in hepatic failure: Preliminary clinical report. Surgery 1987; 101: 99–103.

    PubMed  CAS  Google Scholar 

  28. Margulis MS, Erukhimov EA, Andreiman LA and Viksna LM. Temporary organ substitution by hemoperfusion through suspension of active donor hepatocytes in a total complex of intensive therapy in patients with acute hepatic insufficiency. Resuscitation 1989; 18: 85–94.

    Article  PubMed  CAS  Google Scholar 

  29. Sussman NL, Chong MG, Koussayer T, He D-E, Shang TA et al. Reversal of fulminant hepatic failure using an extracorporeal liver assist device. Hepatology 1992; 16: 60–65.

    Article  PubMed  CAS  Google Scholar 

  30. Kelly JH, Koussayer T, He D-E, Chong MG, Shang TA et al. Assessment of an extracorporeal liver assist device in anhepatic dogs. Artificial Organs 1992; 16: 418422.

    Google Scholar 

  31. Sussman NL and Kelly JH. Improved liver function following treatment with an extracorporeal liver assist device. Artificial Organs 1993; 17: 27–30.

    Article  PubMed  CAS  Google Scholar 

  32. Sussman NL, Finegold MJ, Barish JP and Kelly JH. A case of syncytial giant-cell hepatitis treated with an extracorporeal live assist device. Am J Gastroent 1994; 89: 1077–1082.

    PubMed  CAS  Google Scholar 

  33. Sussman NL, Gislason GT, Conlin CA and Kelly JH. The Hepatix extracorporeal liver assist device: Initial clinical experience. Artificial Organs 1994; 18: 390–396.

    Article  PubMed  CAS  Google Scholar 

  34. Ellis AJ, Hughes RD, Wendon JA, Dunne J, Langley PG et al. Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure. Hepatology 1996; 24: 1446–1451.

    Article  PubMed  CAS  Google Scholar 

  35. McCarthy M, Ellis AJ, Wendon JA, Heaton N, Rela M et al. Use of extracorporeal liver assist device and auxilliary liver transplantation in fulminant hepatic failure. Eur J Gastroent Hepatol 1997; 9: 407–412.

    Article  CAS  Google Scholar 

  36. Rozga J, Williams F, Roo M-S, Neuzil DF, Giorgio TD et al. Development of a bioartificial liver: Properties and function of a hollow-fiber module inoculated with liver cells. Hepatology 1993; 17: 2558–265.

    Article  Google Scholar 

  37. Rozga J, Holzman MD, Roo M-S, Griffin DW, Neuzil DF et al. Development of a hybrid bioartificial liver. Ann Surg 1993; 217: 502–511.

    Article  PubMed  CAS  Google Scholar 

  38. Rozga J, Podesta L, Le Page E, Hoffman A, Morsiani E et al. Control of cerebral oedema by total hepatectomy and extracorporeal liver support in fulminant hepatic failure. The Lancet 1993; 342: 898–899.

    Article  CAS  Google Scholar 

  39. Neuzil DF, Rozga J, Moscioni AD, Roo M-S, Hakim R et al. Use of a novel bioartificial liver in a patient with acute liver insufficiency. Surgery 1993; 113: 340343.

    Google Scholar 

  40. Rozga J, Podesta L, Le Page E, Morsiani E, Hoffman A et al. A bioartificial liver to treat severe acute liver failure. Ann Surg 1994; 219: 538–546.

    Article  PubMed  CAS  Google Scholar 

  41. Demetriou AA, Rozga J, Podesta L, Le Page E, Morsiani E et al. Early clinical experience with a hybrid bioartificial liver. Scand J Gastroenterol 1995; 30 (Suppl. 208): 111–117.

    Article  Google Scholar 

  42. Watanabe FD and Demetriou AA. Support of acute liver failure patients with a bioartificial liver. J Clin Apheresis 1996; 11: 138–142.

    Article  PubMed  CAS  Google Scholar 

  43. Chen SC, Mullon C, Kahaku E, Watanabe F, Hewitt W et al. Treatment of severe liver failure with a bioartificial liver. Ann NY Acad Sci 1997; 831 (Bioartificial organs): 350–360.

    Article  PubMed  CAS  Google Scholar 

  44. Watanabe FD, Mullon CJ-P, Hewitt WR, Arkadopoulos N, Kahaku E et al. Clinical experience with a bioartificial liver in the treatment of severe liver failure. A phase 1 clinical trial. Ann Surg 1997; 225: 484–494.

    Article  PubMed  CAS  Google Scholar 

  45. Bismuth H. New developments in clinical use of a bioartificial liver. In: Crepaldi G, Demetriou AA and Muraca M. eds. Bioartificial Liver Support: The Critical Issues. Italy: C.I.C. Edizioni Internationali, 1997:

    Google Scholar 

  46. Nyberg SL, Shatford RA, Peshwa MV, White JG, Cerra FB et al. Evaluation of a hepatocyte entrapment hollow fiber bioreactor: A potential bioartificial liver. Biotechnol Bioeng 1993; 41: 194–203.

    Article  PubMed  CAS  Google Scholar 

  47. Nyberg SL, Platt JL, Shirabe K, Payne WD, Hu W-S et al. Immunoprotection of xenocytes in a hollow fiber bioartificial liver. ASAIO Journal 1992; 38: M463 - M467.

    Article  PubMed  CAS  Google Scholar 

  48. Nyberg SL, Payne WD, Amiot B, Shirabe K, Remmel RP et al. Demonstration of biochemical function by extracorporeal xenohepatocytes in an anhepatic animal model. Transplantation Proc 1993; 25: 1944–1945.

    CAS  Google Scholar 

  49. Sielaff TD, Hu MY, Amiot B, Rollins MD, Rao S et al. Gel-entrapment bioartificial liver therapy in galactosamine hepatitis. J Surg Res 1995; 59: 179–184.

    Article  PubMed  CAS  Google Scholar 

  50. Wu FJ, Friend JR, Lazar A, Mann HJ, Remmel RP et al. Hollow fiber bioartificial liver utilizing collagen entrapped porcine hepatocyte spheroids. Biotechnol Bioeng 1996; 52: 34–44.

    Article  PubMed  CAS  Google Scholar 

  51. Hu W-S, Friend JR, Wu FJ, Sielaff T, Peshwa MV et al. Development of a bioartificial liver employing xenogenic hepatocytes. Cytotechnology 1997; 23: 29–38.

    Article  PubMed  CAS  Google Scholar 

  52. Gerlach JC, Kloppel K, Muller C, Smith MD and Neuhaus P. Hepatocyte aggregate culture technique for bioreactors in hybrid liver support systems. Int J Artific Org 1993; 16: 843–846.

    CAS  Google Scholar 

  53. Gerlach J, Schnoy N, Smith MD and Neuhaus P. Hepatocyte culture between woven capillary networks: A microscopy study. Artificial Organs 1994; 18: 226–230.

    Article  PubMed  CAS  Google Scholar 

  54. Gerlach, J, Encke J, Hole O, Muller C, Ryan CJ et al. Bioreactor for a larger scale hepatocyte in vitro perfusion. Transplantation 1994; 58: 984–988.

    Article  PubMed  CAS  Google Scholar 

  55. Fuchs M, Gerlach J, Encke J, Smith MD, Neuhaus P et al. Amino acid metabolism by hepatocytes in a hybrid liver support bioreactor. Int J Artific Org 1994; 17: 663–669.

    CAS  Google Scholar 

  56. Fuchs M, Gerlach J, Unger J, Encke J, Smith MD et al. a-keto acid metabolism by hepatocytes cultured in a hybrid liver support bioreactor. Int J Artific Org 1994; 17: 554–558.

    CAS  Google Scholar 

  57. Gerlach J, Trost T, Ryan CJ, Meissler M, Hole O et al. Hybrid liver support system in a short term application on hepatectomized pigs. Int J Artific Org 1994; 17: 549–553.

    CAS  Google Scholar 

  58. Gerlach JC. Development of a hybrid artificial liver: A review. Inte J Artific Org 1996; 19: 645–654.

    CAS  Google Scholar 

  59. Flendrig LM, la Soe JW, Jorning GGA, Steenbeek A, Karlsen OT et al. In vitro evaluation of a novel bioreactor based on an integral oxygenator and a spirally wound nonwoven polyester matrix for hepatocyte culture as small aggregates. J Hepatol 1997; 26: 1379–1392.

    Article  PubMed  CAS  Google Scholar 

  60. Flendrig LM, to Velde AA and Chamuleau RAFM. Semipermeable hollow fibre membranes in hepatocyte bioreactors: A prerequisite for a successful bioartificial liver? Artificial Organs 1997; 21: 1177–1181.

    Article  PubMed  CAS  Google Scholar 

  61. Flendrig LM, Di Florio E, Mancini A, Vacca C, Evangelista A et al. In vivo investigation of a novel bioartificial liver (BAL) based on porcine hepatocytes. Hepatology 1997; 26 (4 pt.2 SS): 168A.

    Google Scholar 

  62. Bader A, Knopp E, Boeker K, Schuettler W, Oldhafer K et al. A novel bioreactor design for in vitro reconstruction of in vivo liver characteristics. Artificial Organs 1995; 19: 368–374.

    Article  PubMed  CAS  Google Scholar 

  63. Bader A, Knopp E, Fruehauf N, Crome O, Boeker K et al. Reconstruction of liver tissue in vitro: geometry characteristic of flat bed, hollow fiber and spouted bed bioreactors with reference to the in vivo liver. Artificial Organs 1995; 19: 941–950.

    Article  PubMed  CAS  Google Scholar 

  64. Bader A, Fruehauf N, Steinhoff G and Haverich A. Development of a bioartificial liver by reconstructing 3-D cell plates and sinusoidal analogues. Artificial Organs 1997; 21: 526.

    Google Scholar 

  65. Smith MD, Airdrie I, Cairns D, Cousins RB, Ekevall E et al. A novel hybrid artificial liver with integral membrane oxygenation: Theory and initial in vitro evaluation. In: International Congress on Hepatocytes: Applications in cell biology, toxicology and medicine. Kluwer Academic Publishers, Germany, 1996.

    Google Scholar 

  66. Smith MD, Airdrie I, Cairns D, Courtney JM, Cousins RB et al. Characterisation of a hybrid artificial liver bioreactor with integral membrane oxygenation. Artificial Organs, 1997; 21: 531.

    Google Scholar 

  67. Ekevall E, Smith MD, Airdrie I, Grant MH, Cousins RB et al. A modular hepatocyte bioreactor with integral membrane oxygenation: In vitro testing. Int J Artific Org 1997; 20: 529.

    Google Scholar 

  68. Smith MD, Airdrie I, Courtney JM, Cousins RB, Ekevall E et al. Development and characterization of a hybrid artificial liver bioreactor with integral membrane oxygenation. In: Crepaldi G, Demetriou AA and Muraca M, Eds. Bioartificial Liver Support: The Critical Issues. Italy: C.I.C. Edizioni Internationali, 1997: 27–35.

    Google Scholar 

  69. Zieve L, Doizaki WM and Zieve FJ. Synergism between mercaptans and ammonia or fatty acids in the production of coma: A possible role for mercaptans in the pathogenesis of hepatic coma. J Lab Clin Med 1974; 83: 16–28.

    PubMed  CAS  Google Scholar 

  70. Nishikawa M, Uchino J, Matsushita M, Takahashi, M, Taguchi K et al. Optimal oxygen tension conditions for functioning cultured hepatocytes in vitro. Artificial Organs 1996; 20: 169–177.

    Article  PubMed  CAS  Google Scholar 

  71. Bhatia SN, Toner M, Foy BD, Rotem A, O’Neil KM et al. Zonal liver cell heterogeneity: effects of oxygen on metabolic functions of hepatocytes. Cellular Engineering 1996; 1: 125–135.

    Google Scholar 

  72. UK government clears animal to human transplant trials under strict guidelines. In: Clinica. 1998: 5.

    Google Scholar 

  73. Takahashi M, Ishikara H, Takahashi C, Nakajima Y, Matsushita M et al. Immunologic considerations in the use of cultured porcine hepatocytes as a hybrid artificial liver. ASAIO Journal 1993; 39: M242 - M246.

    Article  PubMed  CAS  Google Scholar 

  74. Gerlach JC. Long-term liver cell cultures in bioreactors and possible application for liver support. Cell Biol Toxicol 1997; 13: 349–355.

    Article  PubMed  CAS  Google Scholar 

  75. Joly A, Desjardins J-F, Fremond B, Desille M, Campion J-P et al. Survival, proliferation and functions of porcine hepatocytes encapsulated in coated alginate beads: a step towards a reliable bioartificial liver. Transplantation 1997; 63: 795–803.

    Article  PubMed  CAS  Google Scholar 

  76. Stockman HBAC, Tompkins RG and Berthiaume F. Expression of long-term liver-specific function by adult rat hepatocytes cultured on microcarriers. Tissue Engineering 1997; 3: 267–279.

    Article  Google Scholar 

  77. Kern A, Bader A, Pichlmayer R and Sewing K-F. Drug metabolism in hepatocyte sandwich cultures of rats and humans. Biochem Pharmacol 1997; 54: 761–772.

    Article  PubMed  CAS  Google Scholar 

  78. Hansen LK, Hsiao C-C, Friend JR, Wu FJ, Bridge GA et al. Enhanced morphology and function in hepatocyte spheroids: a model of tissue self assembly. Tissue Engineering 1998; 4: 65–74.

    Article  Google Scholar 

  79. Smith MD, Cairns DE, Veitch R, Cousins RB et al. Analysis of oxygen transfer in hollow fibre hepatocyte bioreactors. Artificial Organs 1997; 21: 531.

    Google Scholar 

  80. Smith MD. A hybrid artificial liver with integral membrane oxygenation: Theory, developmental studies and prototype testing. In: PhD Thesis, Bioengineering Unit, University of Strathclyde, Glasgow, UK, 1998: pp 205.

    Google Scholar 

  81. Myers JD. The hepatic blood flow and splanchnic oxygen consumption of man–Their estimations from urea production or bromosulpthalein during catheterisation of the hepatic veins. J Clin Invest 1947; 26: 1130–1137.

    Article  CAS  Google Scholar 

  82. Rotem A, Toner M, Tompkins RG and Yarmush ML. Oxygen uptake in cultured rat hepatocytes. Biotechnol Bioeng 1992; 40: 1286–1291.

    Article  PubMed  CAS  Google Scholar 

  83. Catapano G and De Bartolo LD. Importance of the kinetic characterization of liver cell metabolic reactions to the design of hybrid liver support devices. Int J Art Org 1996; 19: 670–676.

    CAS  Google Scholar 

  84. Griffith LG, Wu B, Cima MJ, Powers MJ, Chaignaud B et al. In vitro organogenesis of liver tissue. Ann NY Acad Sci 1998; 831 (Bioartificial Organs): 382–397.

    Article  Google Scholar 

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Michael N. Berry Anthony M. Edwards

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Smith, M., Grant, M.H., Cousins, R.B., Gaylor, J.D.S. (2000). A review of bioartificial liver development from an artificial organ engineering perspective. In: Berry, M.N., Edwards, A.M. (eds) The Hepatocyte Review. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-3345-8_30

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