An Experimental Artificial Liver Utilizing Extracorporeal Metabolism with Sliced or Granulated Canine Liver

Abstract

Guest Editor's Introduction: This paper was originally presented at the 9th congress of ASAIO in April 1963. The original paper was printed in Volume IX of Trans. Soc. Artif. Int. Organs 1963, pages 358–362. It was reprinted with permission in Therapeutic Apheresis, Volume 4, Issue 1, 2000 as a millennium project of the International Society for Apheresis. This paper describes for the first time a hybrid artificial live and extracorporeal circulatory system composed of a specially developed high permeable gel type cellophane membrane. This membrane separated the patient's blood and the metabolic fluid in which freeze‐dried canine liver granules were contained. Carbohydrate metabolism and ammonia detoxification were maintained in this metabolic chamber, eventually helping the patient's metabolic functions. In addition to experimental studies, four clinical studies were briefly reported.

Clinical Application of Bioartificial Liver Support Systems

“…36 The many different biologic approaches that followed thereafter comprised xeno cross-hemodialysis, in which the patient's blood was dialyzed against blood of a living animal 37 or animal liver tissue preparations. 38,39 Although these techniques could be beneficial to patients with liver failure, they were not considered to be suitable for clinical application because of the complexity of the procedure or rapid loss of effectivity. Moreover, xenogeneic extracorporeal liver perfusion in humans temporarily had been shown to improve biochemical parameters and the patient's clinical neurologic condition.…”

Review: Artificial liver support systems

“…Therapeutic gains, however, were short-lived. Nose et al 48 utilized various canine liver tissue preparations (homogenate, fresh liver slices) in a dialyzer in which animal blood was separated by a gel-type cellophane membrane. With this method, limited beneficial effects on glucose homeostasis, acidosis, and hyperammonemia were observed.…”

Review article: liver support systems in acute hepatic failure

“…The concept of hybrid support was introduced in the last section, and was developed by the pioneers Kimoto and Hori. 85,86 Their techniques were used by others and cleverly adapted by Mikami et al 87 and Nose et al 88 An extra-corporeal circuit was used to assess the function of liver tissue homogenate, fresh liver slices and freeze-dried granules of liver tissue in clinical trials. Patients were connected to a dialysis circuit, and blood was then passed to a`metabolic circuit' which contained a gel-type cellulose membrane, a bubble oxygenator and a chamber or`bioreactor' containing either liver homogenate, liver slices or freeze-dried granules.…”