Gerlach J C, Zeilinger K, Sauer I M, Mieder T, Naumann G, Grünwald A, Pless G, Holland G, Mas A, Vienken J, Neuhaus P
Department of Surgery, Charité, Campus Virchow, Humboldt University, Berlin, Germany.
Int J Artif Organs. 2002 Oct;25(10):1013-8. doi: 10.1177/039139880202501017.
Initial results of the clinical use of primary porcine liver cells for extracorporeal liver support are being reviewed as the cell source is controversial. According to Eurotransplant data 20-25% of explanted donor livers are not transplanted, due to factors such as steatosis or cirrhosis. This number corresponds to the number of patients with acute liver failure who require bridging therapy to transplantation. Primary human liver cells from transplant discards can be isolated, purified and maintained in bioreactors and provide an alternative for cell-based extracorporeal liver support therapy. A four-compartment bioreactor enables recovery from preservation and isolation injury in a three-dimensional network of interwoven capillary membranes with integrated oxygenation, rendering the liver cells from these discarded donor organs viable for clinical utilization. Patient contact with additional animal-derived biomatrix and fetal calf serum can be avoided. The initiation of an in vitro cultivation phase allows cell stabilization, quality control, and immediate availability of a characterized system without cryopreservation. The hypothesis of this paper is that with appropriate logistics and four-compartment bioreactor technology, cells from human liver transplant discards can serve the demand for cell-based therapy, including extracorporeal liver support.
由于细胞来源存在争议，目前正在对原代猪肝细胞用于体外肝脏支持的临床应用初步结果进行评估。根据欧洲器官移植协会的数据，20%至25%的切除供肝因脂肪变性或肝硬化等因素未被移植。这个数字与需要移植桥接治疗的急性肝衰竭患者数量相当。来自移植废弃组织的原代人肝细胞可以在生物反应器中分离、纯化和维持，并为基于细胞的体外肝脏支持治疗提供一种替代方案。一种四室生物反应器能够在具有集成氧合功能的交织毛细血管膜三维网络中从保存和分离损伤中恢复，使这些废弃供体器官的肝细胞能够用于临床。可以避免患者接触额外的动物源性生物基质和胎牛血清。体外培养阶段的启动允许细胞稳定、质量控制，并提供一个无需冷冻保存的经过表征的系统，随时可用。本文的假设是，通过适当的物流和四室生物反应器技术，来自人类肝脏移植废弃组织的细胞可以满足基于细胞的治疗需求，包括体外肝脏支持。
