The Bio-Artificial Liver By Michael Hitchiner

Acute Liver Failure Acute liver failure is loss of liver function that occurs rapidly — in days or weeks —usually in a person who has no pre-existing liver disease. Less common than chronic liver failure, which develops more slowly. Also known as fulminant hepatic failure, it can cause serious complications, including excessive bleeding and increasing pressure in the brain. It's a medical emergency that requires hospitalization. Depending on the cause, acute liver failure can sometimes be reversed with treatment. Unfortunately, a liver transplant is often the only cure.

The Liver And You What the liver does is filter your blood and removes harmful toxins that could damage other organs in your body There are still a few drugs and diseases that can lead to acute liver failure

The Bio-Artificial Liver The purpose of the bio-artificial liver device (BAL- Device) is to support the liver during acute liver failure The BAL device does not, currently, replace the liver The supportive roles it plays gives your real liver a chance to heal and regenerate, or to fill in for your liver if a transplant is required The BAL is essentially a bioreactor, embedded with hepatic cells that can process blood plasma separated from the rest of the blood components

How It Works Below is the ELAD Cartridge, one of many designs for the extracorporeal BAL. HepatAssist made by Arbios is a system that uses cryopreserved porcine hepatocytes in an environment similar to the ELAD. It was designed to treat acute liver failure and acute on chronic liver failure in patients with little remaining liver function. The advantage of using porcine cells is that they are available in large quantities. The cells are immobilized in the bioreactor by a membrane in order to prevent an immune response in the patient. Hepatassist became the first bioartificial liver assist device tested in FDA approved phase 2/3 clinical trials.

Testing Something New… Research and laboratory experiments were undergone involving creating an immune- protected xenogeneic bioartificial liver in mice in order to test the regenerative abilities Taking native hepatocytes and restructuring them to form artificial liver tissue that can regenerate remaining liver

Trials and Results Up to 90% of the mouse liver was removed in order to test regenerative abilities in extreme conditions. Immunoprotective assembled hepatocytes were implanted in place of the removed liver. After 2 weeks, the liver was almost entirely regenerated. The artificial liver tissue retained its structure and went on to functionally replace the removed liver tissue.

Challenges Maintenance of cells (viability and functionality) Cost Cell availability Regulatory issues Emergency care complications

Present and Future Cheaper Implantable Smaller/lighter weight All organic Can fully replace liver Can regenerate liver faster More active cell isolation

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