Concise Review: Liver Regenerative Medicine: From Hepatocyte Transplantation to Bioartificial Livers and Bioengineered Grafts

Abstract

Donor organ shortage is the main limitation to liver transplantation as a treatment for end-stage liver disease (ESLD) and acute liver failure (ALF). Liver regenerative medicine may in the future offer an alternative form of therapy for these diseases, be it through cell transplantation, bioartificial liver (BAL) devices, or bioengineered whole organ liver transplantation. All three strategies have shown promising results in the past decade. However, before they are incorporated into widespread clinical practice, the ideal cell type for each treatment modality must be found, and an adequate amount of metabolically active, functional cells must be able to be produced. Research is ongoing in hepatocyte expansion techniques, use of xenogeneic cells, and differentiation of stem cell-derived hepatocyte-like cells (HLCs). HLCs are a few steps away from clinical application, but may be very useful in individualized drug development and toxicity testing, as well as disease modeling. Finally, safety concerns including tumorigenicity and xenozoonosis must also be addressed before cell transplantation, BAL devices, and bioengineered livers occupy their clinical niche. This review aims to highlight the most recent advances and provide an updated view of the current state of affairs in the field of liver regenerative medicine.

Improving Hepatocyte Engraftment Following Hepatocyte Transplantation Using Repeated Reversible Portal Vein Embolization in Rats

“…Indeed, spontaneous hepatocyte engraftment following HT is limited, estimated to represent <1% of total liver mass . In order to obtain clinical improvement of metabolic disorders, a 5%‐10% engraftment rate is thought to assure a sufficient quantity of the missing enzyme or protein …”

Autologous Hematopoietic Stem Cell Transplantation in Sub-Terminal Liver Disease Patients

“…They were divided into 3 groups: Group I:-Consists of 10 patients with liver cirrhosis on top of HCV they were selected as Child C with scoring range from (14)(15)(16)(17)(18)(19)(20)(21) this group was injected with G-CSF for 5 consecutive days to mobilize stem cells from the bone marrow to peripheral blood, their age range between 40-60 years with mean (47 ± 3.4) They were 7 males and 3 females.…”

Tissue Engineering and its Appllication Areas

“…Bu şekilde doku mühendisliği yaklaşımı ile ortaya konan modellerin gelecekte biyoyapay karaciğerler olarak yenileyici tıp yaklaşımında yer bulması mümkün-dür. 30 Karaciğer doku mühendisliği alanındaki bir diğer önemli nokta karaciğerde mikrovasküler yapının ortaya konmasıdır. 2016 yılında, Lee ve ark.…”