Effect of ELAD Liver Support on Plasma HGF and TGF–β<sub>1</sub> in Acute Liver Failure

Miwa, Yoshiyuki; Aj, Ellis; Hughes, Rhidian; Pg, Langley; Ja, Wendon; Williams, Roger

doi:10.1177/039139889601900406

Cited by 25 publications

(12 citation statements)

References 16 publications

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“…(15) reported that the addition of selective filter membranes, which have similar sieving coefficients to EC‐4A, to the PE circuit expedited liver regeneration and improved survival time in pigs with fulminant hepatic failure. We have attempted to detect the HGF changes after PE; however, it has previously been noted that an injection of heparin to patients induced an immediate rise of serum HGF and interfered with HGF detection (16,17).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Plasma Exchange With Different Membrane Pore Sizes in the Treatment of Severe Viral Hepatitis

Li¹,

Liu²,

Xu³

et al. 2005

Ther Apher Dial

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Plasma exchange has become an effective mode of blood purification in patients suffering from liver failure. To assist in patient recovery, we compared two plasma separators to identify a plasma separator with suitable pore sizes to remove toxic substances effectively, and retain important plasma components. The study focused on severe viral hepatitis patients. Of 206 rounds of plasma exchange, 137 were completed with the PS-06 plasma separator (membrane pore size=0.2 microm) and 69 with the EC-4A plasma separator (membrane pore size=0.03 microm). The efficacy of different plasma separators was compared using survival rate, changes in liver biochemistry, immunoglobulin, and complement parameters. The survival rate of patients treated with PS-06 was 43.3% (13 of 30 patients). For patients treated with EC-4A, two patients were bridged to liver transplantation successfully, and 57.9% (11 of 19 patients) survived. In both groups, the levels of total bilirubin, prothrombin time, and bile acid declined significantly. Compared to PS-06, EC-4A could retain significantly larger amounts of immunoglobulin and complements. Our study revealed that plasma exchange implementation with membrane pore size 0.03 microm could remove adequate bilirubin and bile acid, a class of toxins bound to plasma protein in severe viral hepatitis patients, and reduce the loss of essential plasma macromolecules.

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Section: Discussionmentioning

confidence: 99%

Comparison of Plasma Exchange With Different Membrane Pore Sizes in the Treatment of Severe Viral Hepatitis

Li¹,

Liu²,

Xu³

et al. 2005

Ther Apher Dial

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“…Although there is some evidence relating to the harmful substances found in the blood in these circumstances, it is not clear how they act, or if filtering them out has any detrimental effect. Indeed some may be required to stimulate hepatic regeneration and the effect of these systems on hepatic regeneration has yet to be fully assessed 100,101 .…”

Section: Discussionmentioning

confidence: 99%

“…Indeed some may be required to stimulate hepatic regeneration and the effect of these systems on hepatic regeneration has yet to be fully assessed. 100,101 The literature is difficult to interpret due to the differences in end-points used for different models (i.e. improvement in hepatic encephalopathy, survival after hepatic coma or successful bridging to transplant).…”

Section: Discussionmentioning

confidence: 99%

Bioartificial liver support devices: historical perspectives

Court

Wemyss‐Holden

Dennison

et al. 2003

ANZ Journal of Surgery

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Fulminant hepatic failure (FHF) is an important cause of death worldwide. Despite significant improvements in critical care therapy there has been little impact on survival with mortality rates approaching 80%. In many patients the cause of the liver failure is reversible and if short-term hepatic support is provided, the liver may regenerate. Survivors recover full liver function and a normal life expectancy. For many years the only curative treatment for this condition has been liver transplantation, subjecting many patients to replacement of a potentially self-regenerating organ, with the lifetime danger of immunosuppression and its attendant complications, such as malignancy. Because of the shortage of livers available for transplantation, many patients die before a transplant can be performed, or are too ill for operation by the time a liver becomes available. Many patients with hepatic failure do not qualify for liver transplantation because of concomitant infection, metastatic cancer, active alcoholism or concurrent medical problems. The survival of patients excluded from liver transplantation or those with potentially reversible acute hepatitis might be improved with temporary artificial liver support. With a view to this, bioartificial liver support devices have been developed which replace the synthetic, metabolic and detoxification functions of the liver. Some such devices have been evaluated in clinical trials. During the last decade, improvements in bioengineering techniques have been used to refine the membranes and hepatocyte attachment systems used in these devices, in the hope of improving function. The present article reviews the history of liver support systems, the attendant problems encountered, and summarizes the main systems that are currently under evaluation.

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“…The value of continuous BAL application over several days has also been questioned. Such continuous application may be detrimental to patient outcomes via the removal of important stimulators of hepatic regeneration such as Hepatocyte growth factor (34). Significantly the HepatAssist ® BAL has employed an intermittent 6 h application schedule to help overcome this potential problem and the logistical issues associated with continuous application.…”

Section: Discussionmentioning

confidence: 99%

Maintenance of integrity and function of isolated hepatocytes during extended suspension culture at 25°C

Wigg

Phillips

Berry

2003

Liver International

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Isolated hepatocytes in suspension provide a number of advantages for use in bioartificial liver device, however, poor stability of this cell preparation at physiological temperatures is an apparent barrier preventing their use. We therefore investigated the integrity and differentiated function of isolated rat hepatocytes under conditions of mild hypothermia. Isolated hepatocytes were suspended in a bicarbonate buffered saline medium, supplemented with glucose and bovine serum albumin (BSA), and maintained for 48 h at 25 degrees C on a rotary shaker under an atmosphere of 95% O2 and 5% CO2. Under these conditions there was no significant decline in cell viability and good preservation of cellular morphology on transmission electron microscopy for at least 24 h. Isolated hepatocytes in suspension at 25 degrees C were also able to maintain normal Na+ and K+ ion gradients. The cellular energy status ([ATP], ATP/ADP ratio, cytoplasmic and mitochondrial redox potentials), metabolic function (urea synthesis and ammonia removal), albumin synthesis and phase I and phase II drug detoxification activity of these cells were also maintained for at least 24 h post isolation. These observations demonstrate the robust nature of mildly hypothermic isolated hepatocytes in suspension and encourage further studies re-examining the feasibility of using this cell preparation in bioartificial livers.

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Effect of ELAD Liver Support on Plasma HGF and TGF–β₁ in Acute Liver Failure

Cited by 25 publications

References 16 publications

Comparison of Plasma Exchange With Different Membrane Pore Sizes in the Treatment of Severe Viral Hepatitis

Comparison of Plasma Exchange With Different Membrane Pore Sizes in the Treatment of Severe Viral Hepatitis

Bioartificial liver support devices: historical perspectives

Maintenance of integrity and function of isolated hepatocytes during extended suspension culture at 25°C

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Effect of ELAD Liver Support on Plasma HGF and TGF–β1 in Acute Liver Failure

Cited by 25 publications

References 16 publications

Comparison of Plasma Exchange With Different Membrane Pore Sizes in the Treatment of Severe Viral Hepatitis

Comparison of Plasma Exchange With Different Membrane Pore Sizes in the Treatment of Severe Viral Hepatitis

Bioartificial liver support devices: historical perspectives

Maintenance of integrity and function of isolated hepatocytes during extended suspension culture at 25°C

Contact Info

Product

Resources

About

Effect of ELAD Liver Support on Plasma HGF and TGF–β₁ in Acute Liver Failure