Cataldo Doria, M.D., Ph.D., Nicoletti Family Professor of Transplant Surgery at Jefferson Medical College of Thomas Jefferson University, and director of the Division of Transplantation at Thomas Jefferson University Hospital is the first transplant surgeon in the United States to use a new totally artificial liver assist device as a bridge to transplantation.
"If a patient is a suitable candidate for liver transplantation, the wait for an organ may prove to be too long," said Dr. Doria. "By using a totally artificial liver assist device as a bridge to transplantation, we can 'buy time' either for the liver to recover itself or until a suitable organ becomes available."
A totally artificial liver assist device was successfully used on a patient diagnosed with fulminant hepatic failure requiring a transplant. It was needed to keep the patient alive until a donor organ could be located. The liver assist device utilizes a machine with a synthetic filtering system that does not use any human or animal cell lines to replace the detoxifying function of the liver which, when absent in liver failure, is life threatening. The synthetic filtering system allows for the removal of water soluble and protein bound toxins, which can accumulate in liver failure. These special filters detoxify a patient's blood before it re-enters the body, thus allowing a patient more time to find a suitable donor liver, or in some cases allow the damaged organ to heal itself. Similar systems are available but they utilize either pig or human liver cells to act as an artificial liver.
The liver is an organ that looks after metabolism and detoxification of the body. Liver failure is often caused by the intake of poisonous drugs or substances, which can damage large parts of the liver beyond repair causing it to no longer function properly. It can also be caused by certain viruses, long-term consumption of alcohol, malnutrition and genetic disorders. Most often liver failure occurs gradually and over many years. However, a more rare condition known as acute liver failure occurs rapidly and can be difficult to detect initially. Causes of acute liver failure can include acetaminophen overdose or accidental poisonings.
If detected early enough, acute liver failure caused by an overdose of acetaminophen or accidental poisoning can sometimes be treated and its effects reversed. If this is not possible, then a liver transplant is required. Fortunately, liver transplant is a common procedure that is often successful but only if a viable organ is available in enough time.
Jefferson Medical College, Thomas Jefferson University