Current Approach to Diagnosis and Treatment for Liver Failure (Literature Review)

Introduction. To date, according to WHO, liver failure (LF) is one of the ten leading causes of death in the elderly in developing countries. In developed countries, LF occurs in 0.03% of the population, but mortality and complication rate remain high. WHO predicts that in the next 10-20 years, mortality from liver diseases will increase by 2 times. In this regard, prevention and treatment of liver failure is of great medical and social significance, remains relevant and requires in-depth study on biological models.The aim of the study was to systematize the data on modern approaches to study liver failure on biological models.Material and methods. The authors reviewed data in PubMed, Cochrane Library, ScienceDirect, eLIBRARY. The search was conducted on the keywords "liver failure", biological model, "liver surgery", "liver failure", "modeling of liver failure", "biological model" and limited to the period 2010-2021. In addition, a manual search of papers in the peer-reviewed journals was carried out. Criteria for exclusion were: description of individual clinical cases, data from books and documents, comparison of clinical outcomes. Out of 109 initially identified sources, 40 sources were included in the final analysis.Results. To date, there are several ways to simulate acute liver failure: surgical, toxic and combined. Chronic liver failure is also simulated diversely: toxically (tetrachloromethane, thioacetamide, dipin, sovtol-1, etc.); surgically (ligation of the bile ducts); dietarily (choline-deficient, etc.); genetically (introduction of exogenous genes into the germ line, combination of hepatotoxins with hepatocarcinogens). As stated, LF simulation has features associated with a high rate of regenerative processes in the liver; the fact allowing it to compensate for damage relatively quickly.Conclusion. There are many techniques to simulate hepatic pathology, differing in damaging factors, the degree of damage and the reversibility of the process, different manifestations of biochemical and morphological changes. When choosing an option to reproduce liver failure, the researcher should take into account the advantages and disadvantages of the model, the conditions for conducting and the expected result of the experiment, and also choose the model that most accurately illustrates the clinical picture of this pathological condition.

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Regenerative effect tissue engineering scaffold based on fibrous permeable TiNi-based alloy

Kokorev

Dambayev

Марченко

et al. 2022

ВХ

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The aim of this study was to explore the in vivo applicability of intracorporeal constructions with hepatocytes cultured in the fiber TiNi-based scaffold (FTNS). We also sought to determine whether application of hepatocytes cultured in the FTNS was superior to simple hepatocyte injection in terms of restoration of liver functions and survival time in a CCl4-induced hepatitis rat model. In investigation 200 animals were assigned to explore the experimental groups as follows: Group I – control; Group II – animals with CCl4-induced hepatitis; Group III – animals with toxic hepatitis followed by implantation of cell-free FTNS (sham-surgery); Group IV – animals with toxic hepatitis followed by infusion of hepatocytes only (20 × 106 cells/ml); Group V – animals with toxic hepatitis followed by implantation of hepatocytes cultured in the FTNS. In terms of restoration of liver function, Group V showed a significant reduction of serum alanine aminotransferase level compared to Group II. Group IV also showed a significant decrease in ALT level at 15 days. However, the level of ALT increased at 30 days, and the level was similar with results of the Group II. This probably was caused by a short-term effect of hepatocyte injection only. The change patterns of serum protein, lactate, albumin, fibrinogen, and total bilirubin levels were similar to the results of ALT. The survival time of animals was significantly longer in Group V. These findings showed possible abilities of the FTNS as a scaffold to support the hepatocellular metabolism. Using 12 animals, image analysis of SEM data of in vivo hepatocyte evolution in the FTNS was carried out. In the SEM analysis, hepatocytes demonstrated good adhesion and proliferation in the pore space of the FTNS. Moreover, mature tissue comprising both colloidal and fibrous components filled the pore body by 95% in 28 days. Overall, this study sheds a light on how the implantable «auxiliary liver» by engrafting the cultured FTNS substitutes the missing hepatic function without the need to replace the whole liver.

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Current Approach to Diagnosis and Treatment for Liver Failure (Literature Review)

Cited by 3 publications

References 31 publications

Multiple organ manifestations of liver failure in acute small bowel obstruction

Multiple organ manifestations of liver failure in acute small bowel obstruction

Modern Approaches to the Study of Liver Failure on Biological Models

Regenerative effect tissue engineering scaffold based on fibrous permeable TiNi-based alloy

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