Bioartificial Liver

Acute Liver failure (ALF) is defined as sudden severe hepatic dysfunction in the setting of a previously healthy Liver. CLinical manifestations of ALF include encephalopathy, coagulopathy, hemodynamic instabiLity, and jaundice. Annual incidence of ALF in the United States is 2500 cases with acetaminophen toxicity representing the most common etiology at 56%. Although some cases of ALF remit spontaneously, mortaLity rates are as high as 60%. Emergency transplantation remains the only definitive treatment for patients; however, with Limited high-quaLity donor organs, alternative therapies including extracorporeal Liver support technologies are needed to serve as a bridge to return of native function or transplantation.Extracorporeal Liver support technologies include both artificial and bioartificial systems. Artificial systems remove toxins via filtration or absorption while bioartificial systems include biochemically active hepatocytes and are capable of performing synthetic functions including protein synthesis, ureagenesis, glucogenesis, and detoxification via the P450 system. A number of cLinical trials have been performed testing artificial and bioartificial Liver (BAL) devices with varying degrees of cLinical success. Widespread cLinical appLication of BAL devices are Limited by an abundant high-quaLity, readily available source of hepatocytes. Future directions for cell source include growth of human cells via in vivo animal models.