Extracorporeal support and hepatocyte transplantation in acute liver failure and cirrhosis
Extracorporeal support and hepatocyte transplantation in acute liver failure and cirrhosis
复制标题
急性肝衰竭和肝硬化的体外支持和肝细胞移植
DOI：
--
复制
发表时间：
1999
影响因子：
4.1
通讯作者：
Roger Williams
中科院分区：
文献类型：
--
作者：
S. Riordan;Roger Williams
供体器官的相对短缺和缺乏即时可用性意味着许多急性肝衰竭患者在进行原位肝移植之前死亡。一个有效的临时肝脏支持系统可以提高最终是否进行移植的生存机会。最近的技术进步改善了培养和生物反应器设计中肝细胞活力和功能的维持，促进了细胞成分的充分灌注和细胞代谢产物的去除，这导致了许多用于肝支持的生物人工装置的发展。三种这样的装置在急性肝衰竭的情况下进行了初步的临床评估，统计上显著降低了升高的颅内压，并改善了意识水平和与其中一种治疗相关的一些生化参数。其他几种具有不同特性的设备已在体外和/或动物模型中显示出前景，但尚待临床评估。随着分离肝细胞移植的出现，一些新的完全人工系统也被描述，并有成功“桥接”到肝移植的报道。需要在明确定义的患者群体中进行多中心对照试验，并采用标准化的结果测量，以正确评估每种方法在急性肝功能衰竭和肝硬化中提供肝脏支持的临床价值。更好地了解多器官衰竭的机制和抑制肝脏再生的因素，从而允许更有针对性的方法，将对这些情况下进一步发展有效的肝脏支持策略至关重要。
The relative shortage of donor organs and lack of immediate availability mean that many patients with acute liver failure die before orthotopic liver transplantation can be performed. An effective temporary liver support system could improve the chance of survival with or without a transplant being ultimately carried out. Recent technological advances resulting in improved maintenance of hepatocyte viability and function in culture and bioreactor designs which facilitate adequate perfusion of the cellular component and removal of products of cellular metabolism have led to the development of a number of bioartificial devices for liver support. Three such devices have undergone preliminary clinical evaluation in the setting of acute liver failure, with a statistically significant reduction in raised intracerebral pressure along with improvements in consciousness level and some biochemical parameters associated with treatment with one of these. Several other devices with different characteristics have shown promise in vitro and/or in animal models but await clinical evaluation. Several new totally artificial systems have also been described, along with the emergence of isolated hepatocyte transplantation, with reports of successful ‘bridging’ to liver transplantation. Controlled trials on a multicentre basis in well‐defined patient groups and with standardized outcome measures will be required to properly evaluate the clinical value of each of these approaches to providing liver support in acute liver failure and cirrhosis. A better understanding of mechanisms underlying multiorgan failure and of factors inhibiting liver regeneration, thereby allowing a more targeted approach, will be essential to the further development of effective liver support strategies in these settings.
登录
查看更多内容
大鼠肝细胞和肝窦细胞共培养物中间质胶原酶的刺激。
影响因子：
29.4
作者：
Kashiwazaki,K;Hibbs,MS;Seyer,JM;Mainardi,CL;Kang,AH
通讯作者：
Kang,AH
两种血清因子控制肝细胞复制。
影响因子：
11.2
作者：
Michalopoulos,G;Houck,KA;Dolan,ML;Leutteke,NC
通讯作者：
Leutteke,NC
培养的大鼠肝细胞中白蛋白基因的转录调控。
DOI：
--
发表时间：
1990
期刊：
Molecular biology & medicine
影响因子：
--
作者：
Bissell,DM;Caron,JM;Babiss,LE;Friedman,JM
通讯作者：
Friedman,JM
生物人工肝治疗严重肝衰竭的临床经验。
影响因子：
9
作者：
Watanabe,FD;Mullon,CJ;Hewitt,WR;Arkadopoulos,N;Kahaku,E;Eguchi,S;Khalili,T;Arnaout,W;Shackleton,CR;Rozga,J;Solomon,B;Demetriou,AA
通讯作者：
Demetriou,AA
通过条件永生化肝细胞移植治疗手术引起的急性肝衰竭。
影响因子：
6.2
作者：
Nakamura,J;Okamoto,T;Schumacher,IK;Tabei,I;Chowdhury,NR;Chowdhury,JR;Fox,IJ
通讯作者：
Fox,IJ