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体外生物人工肝支持系统发展的关键挑战。

Key challenges to the development of extracorporeal bioartificial liver support systems.

机构信息

Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2012 Jun;11(3):243-9. doi: 10.1016/s1499-3872(12)60155-6.

DOI:10.1016/s1499-3872(12)60155-6
PMID:22672816
Abstract

BACKGROUND

For nearly three decades, extracorporeal bioartificial liver (BAL) support systems have been anticipated as promising tools for the treatment of liver failure. However, these systems are still far from clinical application. This review aimed to analyze the key challenges to the development of BALs.

DATA SOURCE

We carried out a PubMed search of English-language articles relevant to extracorporeal BAL support systems and liver failure.

RESULTS

Extracorporeal BALs face a series of challenges. First, an appropriate cell source for BAL is not readily available. Second, existing bioreactors do not provide in vivo-like oxygenation and bile secretion. Third, emergency needs cannot be met by current BALs. Finally, the effectiveness of BALs, either in animals or in patients, has been difficult to document.

CONCLUSIONS

Extracorporeal BAL support systems are mainly challenged by incompetent cell sources and flawed bioreactors. To advance this technology, future research is needed to provide more insights into interpreting the conditions for hepatocyte differentiation and liver microstructure formation.

摘要

背景

近三十年来,体外生物人工肝脏(BAL)支持系统一直被认为是治疗肝功能衰竭的有前途的工具。然而,这些系统仍远未应用于临床。本综述旨在分析 BAL 发展的关键挑战。

资料来源

我们对与体外 BAL 支持系统和肝功能衰竭相关的英文文章进行了 PubMed 检索。

结果

体外 BAL 面临一系列挑战。首先,BAL 的合适细胞来源尚不可用。其次,现有的生物反应器不能提供类似于体内的氧合和胆汁分泌。第三,目前的 BAL 无法满足紧急需求。最后,BAL 在动物或患者中的有效性难以证明。

结论

体外 BAL 支持系统主要受到细胞来源不足和生物反应器设计缺陷的挑战。为了推进这项技术,未来的研究需要深入了解肝细胞分化和肝组织结构形成的条件。

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