Surgery Today

, Volume 35, Issue 7, pp 507–517 | Cite as

Development and Perspectives of Perfusion Treatment for Liver Failure

  • Katsutoshi Naruse
  • Hiroshi Nagashima
  • Yasuyuki Sakai
  • Norihiro Kokudo
  • Masatoshi Makuuchi
Review Article

Abstract

To treat patients with severe liver failure, liver transplantation and blood purification therapy, including plasmapheresis, hemodiafiltration, and bioartificial liver support, are available. The two mainstream systems developed for bioartificial liver support are extracorporeal whole liver perfusion (ECLP) and the bioreactor system (BIS). We developed a method of cross-plasma perfusion, in which plasma is exchanged between the blood circuit of the patient and that of a hepatic functioning unit, through which immunologically free whole human blood is perfused. From the aspects of efficacy and epidemic safety, the best system of bioartificial liver support for clinical use is considered to be ECLP in cross-plasma perfusion. In opposition, a social antagonist for zoonosis has consistently been raised, with controversy surrounding the use of xenogeneic organs for human treatment, which might be final obstacle. It is possible that the combination therapy of hemodiafiltration and the administration of human serum albumin and anticoagulant factors, which minimizes the economic and medical resource costs through the development of transgenic livestock that secrete human pharmaceuticals systemically, will become a more desirable and practical treatment for patients with severe liver failure.

Key words

Bioartificial liver support Blood purification therapy Extracorporeal whole liver perfusion Bioreactor Transgenic pig 

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Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Katsutoshi Naruse
    • 1
  • Hiroshi Nagashima
    • 2
  • Yasuyuki Sakai
    • 3
  • Norihiro Kokudo
    • 1
  • Masatoshi Makuuchi
    • 1
  1. 1.Division of Artificial Organs and Transplantation, Department of Surgery, Faculty of MedicineUniversity of TokyoTokyoJapan
  2. 2.Laboratory of Reproduction Engineering, Faculty of AgricultureMeiji UniversityKawasakiJapan
  3. 3.Institute of Industrial ScienceUniversity of TokyoTokyoJapan

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