Extra-corporeal liver cross-circulation provides comprehensive hepatic support in a porcine model of acute liver failure
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Effective temporary liver support for patients with acute and acute-on-chronic liver failure is an important unmet need. Artificial and bio-artificial liver support systems have not improved survival substantially, reflecting a failure to replace the many, complex roles of a liver. Extra-corporeal liver cross-circulation, in which a patient’s blood is perfused through a donor liver maintained on a machine, may provide more comprehensive hepatic replacement. We have developed and evaluated an extra-corporeal liver cross-circulation (ELC) system in a porcine model of acute liver failure. The system effectively replaced hepatic detoxification, excretory, synthetic, metabolic regulatory and immunologic functions, underpinned by wide-ranging adaptive changes in the plasma proteome and metabolome. This improved prognostically-significant clinical hallmarks of acute liver failure. For clinical application, human livers declined for transplantation or (potentially) livers from genetically-modified pigs may be used on this platform to provide an effective bridge to recovery or transplantation.