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Living Donors, Non-Human Sources, and Cadaveric Donors
Published in David Lamb, Organ Transplants and Ethics, 2020
A major solution to ethical problems posed by animal-to -human and live inter-human donations is to be found in a programme for the development of artificial organs. There are admittedly tremendous difficulties. The artificial heart is at present impracticable and an artificial liver is beyond human capacity. But notwithstanding these difficulties a guiding principle on organ replacement should be to investigate very carefully any proposals that would inhibit such research. In this context proposals for a market in organ sales should be strongly resisted lest they encourage the vested interests of organ suppliers and brokers, who may use all the power at their disposal to discourage alternatives to their lucrative trade.
Human Liver Stem Cells:
Published in Gianfranco Alpini, Domenico Alvaro, Marco Marzioni, Gene LeSage, Nicholas LaRusso, The Pathophysiology of Biliary Epithelia, 2020
For this reason, the concept of a liver stem cell was in doubt for years.3 However, this has now changed to the extent that there is a an extensive literature documenting the many observations.4–5 There is now a great deal of excitement at the prospect of characterising liver stem cells and exploiting their potential for clinical therapies. These include for example, cell transplantation for gene replacement therapy or liver cell repopulation to accelerate liver repair in the critical time period following acute liver failure.6 Additionally hepatic stem cells could prove a valuable source of human hepatocytes for drug development7 or use in bio-artificial liver support systems.8 Since primary hepatocytes are in such limited supply, these efforts continue to be substantially constrained by the shortfall.
Hepatic failure
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
A more promising approach is that of inducing moderate hypothermia with active cooling. In a series of seven patients with refractory elevations in ICP, cooling to a core temperature of 32-33°C reduced ICP, while maintaining CPP and reducing circulating ammonia and cerebral ammonia uptake.66 Hypothermia may inhibit hepatic regeneration, which is a key process in recovery from ALF and thus the application of hypothermia might best be restricted to those patients who are listed for transplantation and awaiting a graft. The use of artificial liver support devices may, in the future, function as adjunctive treatment of HE in ALF but, at present, is restricted to limited experimental trials. Data from a trial of a porcine hepatocyte based bioartificial liver support device79 demonstrated a fall in ICP and rise in CPP during treatment periods, suggesting a potential role as a future bridge to liver transplantation.
Impaired albumin function: a novel potential indicator for liver function damage?
Published in Annals of Medicine, 2019
Lejia Sun, Huanhuan Yin, Meixi Liu, Gang Xu, Xiaoxiang Zhou, Penglei Ge, Huayu Yang, Yilei Mao
Artificial liver is an effective method for treating liver failure. The ability to synthesise and secrete albumin is a vital indicator for testing the function of artificial liver (Su et al. 2014; Damania et al. 2018; Du et al. 2014; Che Abdullah et al. 2014), but researchers only detect the concentration of albumin. Whether albumin synthesised by the artificial liver exhibits the same biological properties as albumin in physiological state is unknown. Albumin function may become an effective indicator for the biological characteristics of the in vitro liver tissue model.
Liver failure in pregnancy: a review of 25 cases
Published in Journal of Obstetrics and Gynaecology, 2021
Mengyao Luo, Lei Gao, Junqi Niu, Chen Chen, He Wang, Ying Chen
Some patients with hepatic encephalopathy or kidney dysfunction receive artificial liver support. Artificial liver support is designed to act as a bridge to regeneration of the liver and its function; however, the benefits of artificial liver support for synthetic functions of the liver are questionable (Karvellas and Subramanian 2016). Published literature shows that artificial liver support can be used to successfully treat patients with liver failure and those in a hepatic coma (Karvellas and Subramanian 2016).