新型多层平板式生物人工肝的评价。
Evaluation of a novel hybrid bioartificial liver based on a multi-layer flat-plate bioreactor.
机构信息
Department of Hepatobiliary Surgery, Jiangsu Province's Key Medical Center for Hepatobiliary Disease, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.
出版信息
World J Gastroenterol. 2012 Jul 28;18(28):3752-60. doi: 10.3748/wjg.v18.i28.3752.
AIM
To evaluate the efficacy and safety of a hybrid bioartificial liver (HBAL) system in the treatment of acute liver failure.
METHODS
Canine models with acute liver failure were introduced with intravenous administration of D-galactosamine. The animals were divided into: the HBAL treatment group (n = 8), in which the canines received a 3-h treatment of HBAL; the bioartificial liver (BAL) treatment group (n = 8), in which the canines received a 3-h treatment of BAL; the non-bioartificial liver (NBAL) treatment group (n = 8), in which the canines received a 3-h treatment of NBAL; the control group (n = 8), in which the canines received no additional treatment. Biochemical parameters and survival time were determined. Levels of xenoantibodies, RNA of porcine endogenous retrovirus (PERV) and reverse transcriptase (RT) activity in the plasma were detected.
RESULTS
Biochemical parameters were significantly decreased in all treatment groups. The TBIL level in the HBAL group was lower than that in other groups (2.19 ± 0.55 μmol/L vs 24.2 ± 6.45 μmol/L, 12.47 ± 3.62 μmol/L, 3.77 ± 1.83 μmol/L, P < 0.05). The prothrombin time (PT) in the BAL and HBAL groups was significantly shorter than the NBAL and control groups (18.47 ± 4.41 s, 15.5 ± 1.56 s vs 28.67 ± 5.71 s, 21.71 ± 3.4 s, P < 0.05), and the PT in the HBAL group was shortest of all the groups. The albumin in the BAL and HBAL groups significantly increased and a significantly higher level was observed in the HBAL group compared with the BAL group (27.7 ± 1.7 g/L vs 25.24 ± 1.93 g/L). In the HBAL group, the ammonia levels significantly decreased from 54.37 ± 6.86 to 37.75 ± 6.09 after treatment (P < 0.05); there were significant difference in ammonia levels between other the groups (P < 0.05). The levels of antibodies were similar before and after treatment. The PERV RNA and the RT activity in the canine plasma were all negative.
CONCLUSION
The HBAL showed great efficiency and safety in the treatment of acute liver failure.
目的
评估杂交型生物人工肝（HBAL）系统治疗急性肝衰竭的疗效和安全性。
方法
通过静脉注射 D-半乳糖胺建立犬急性肝衰竭模型。动物被分为以下几组：HBAL 治疗组（n = 8），犬接受 3 小时的 HBAL 治疗；生物人工肝（BAL）治疗组（n = 8），犬接受 3 小时的 BAL 治疗；非生物人工肝（NBAL）治疗组（n = 8），犬接受 3 小时的 NBAL 治疗；对照组（n = 8），犬未接受其他额外治疗。检测生化参数和存活时间。检测血浆中外源抗体、猪内源性逆转录病毒（PERV）的 RNA 及其逆转录酶（RT）活性的水平。
结果
所有治疗组的生化参数均显著降低。HBAL 组的 TBIL 水平低于其他组（2.19 ± 0.55 μmol/L 比 24.2 ± 6.45 μmol/L、12.47 ± 3.62 μmol/L、3.77 ± 1.83 μmol/L，P < 0.05）。BAL 和 HBAL 组的凝血酶原时间（PT）明显短于 NBAL 和对照组（18.47 ± 4.41 s、15.5 ± 1.56 s 比 28.67 ± 5.71 s、21.71 ± 3.4 s，P < 0.05），且 HBAL 组的 PT 最短。BAL 和 HBAL 组的白蛋白明显增加，HBAL 组的白蛋白水平明显高于 BAL 组（27.7 ± 1.7 g/L 比 25.24 ± 1.93 g/L）。HBAL 组治疗后血氨水平从 54.37 ± 6.86 降至 37.75 ± 6.09，差异有统计学意义（P < 0.05）；与其他组相比，血氨水平差异均有统计学意义（P < 0.05）。抗体水平治疗前后无明显变化。犬血浆中 PERV RNA 和 RT 活性均为阴性。
结论
HBAL 治疗急性肝衰竭具有良好的疗效和安全性。
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