1️⃣ Because of the shortage of available donor organs, death rates from liver failure remain high. Therefore, several temporary liver-assisting therapies have been developed. One of the episodes in season one of the show ‘House MD’ highlights the use of xenogenic perfusion in the management of fulminant hepatic failure. In English, it introduces the concept of perfusing one’s blood through a liver from another person or a member of another species such as a pig to stabilize the condition of some patients with acute liver failure.
2️⃣ Looking into this interesting approach, I learned that only a few patients survived and that studies have shown that it carried no significant advantage over the conventional treatment used at the time. This method was abandoned in the early 1970s because of the successful development of orthotopic liver transplantation and awareness of the possible immunological implications.
3️⃣ At present, the consensus is that the multiple and complex functions of the liver can be replaced only by using the biologic substrate (ie. hepatocytes), whether in a whole liver or in combination with artificial material. This has led researchers to be increasingly interested in the development of a bioartificial liver along with extracorporeal liver perfusion. An artificial liver to be used outside the body, combining metabolically active pig hepatocytes and synthetic materials within a mechanical support structure, is under development.
4️⃣ Although many scientists have diligently worked to develop such a device, the complexity of the liver has continued to serve as a daunting road block. Contrary to the liver, organs such as the heart, lung, kidney and pancreas can be characterized using a simplistic description: the heart pumps, the kidney filters, the lungs are membranes and the pancreas produces insulin. However, a simplistic description of the liver is much harder to portray as it is a filter, a detoxification plant and a synthetic factory, not to mention all of the other obvious yet unclassified functions for which it is responsible.