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J Hepatol. 2003 Oct;39(4):649-53.

Extracorporeal liver support based on primary human liver cells and albumin dialysis--treatment of a patient with primary graft non-function.

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  • 1Charité--Campus Virchow, Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Medical Faculty of the Humboldt University, Augustenburger Platz 1, 13353 Berlin, Germany. igor.sauer@charite.de

Abstract

METHODS:

Following liver transplantation, a 26-year old female suffered from primary non-function of the transplant. The patient was subsequently treated with a modular extracorporeal liver support concept until a suitable organ became available. A bioreactor was charged with human liver cells, obtained from a discarded cadaveric graft (470 g, viability: 60%). The bioreactor was integrated into an extracorporeal circuit with continuous single pass albumin dialysis and continuous veno-venuous hemodiafiltration for detoxification and fluid reduction.

RESULTS:

Over the total system application time of 79 h, a significant reduction of the plasma levels of total bilirubin (21.1 mg/dl at start, 10.1 mg/dl at end of therapy) and ammonia (100 versus 22.7 micromol/l) was achieved. During treatment the patient's neurological status significantly improved from coma stage IV to I permitting extubation. Recovery of kidney function with a urine output of 1325 ml/24 h compared to 45 ml/24 h prior to system application, was noted. Over the treatment period, an improvement of coagulation status was observed. Adverse events were absent.

CONCLUSIONS:

This first successful clinical treatment of a patient with liver failure suggests that a modular approach combining both primary human liver cell bioreactor technology and detoxification methods is promising.

PMID:
12971979
[PubMed - indexed for MEDLINE]
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