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Artificial Liver Extends Lives

BACKGROUND: Each year, more than 6,000 people undergo a liver transplant in the United States, says the Organ Procurement and Transplantation Network. Patients receive donor livers either from someone with a healthy liver who has recently died or a family member who donates part of his or her liver.

The Mayo Clinic says patients who qualify for liver transplants have failed to respond to other medical or surgical treatment for serious problems caused by a liver disorder; need a transplant to replace cancerous tumors of the liver or bile ducts like hepatocellular carcinoma and cholangiocarcinmoa; or need a transplant to cure abnormalities in metabolism that threaten long-term health.

Some diseases that damage the liver to the extent that a patient might need a transplant include Hepatitis B and C, alcoholic liver disease, genetic high cholesterol and liver tumors if they are confined to the liver.

For patients who might otherwise die, a liver transplant is a life-saving operation. About 75 percent of patients survive three years or longer after a transplant, according to the National Institutes of Health.

Risks involved with liver transplants are most serious after surgery. These include a life-long need for immunosuppressive drugs -- which weaken the body's ability to fight off infections -- and transplant rejection. Transplant rejection happens when the body of a patient who has received an organ attacks that transplanted organ. Doctors try to prevent this by "typing" the organ to identify antigens it contains and make the new organ match the patient as closely as possible. However, since no two people are identical, no two people have identical organs.

A DANGEROUS GAP: While 6,000 liver transplants are performed every year, 27,000 die from liver disease. This is in part because it's hard to replace the functions of the liver without a transplant. Dialysis can provide good support for failed kidneys, various assistive devices can sustain a failed heart, but options like that aren't available for failed livers.

"The attempt to provide liver support has been far more challenging because most of those efforts were largely focused on trying to replace the filtering capabilities of the liver without replacing the synthetic functions, or the things that the liver cell makes that are also missing in the failing liver," Robert S. Brown, Jr., M.D., a liver disease and liver transplant specialist at NewYork-Presbyterian Hospital/Columbia in New York, N.Y., said.

A NEW SOLUTION: A new out-of-body artificial liver is addressing the problem by essentially doing what dialysis does for kidneys. A patient's plasma passes through the dialysis membrane in the machine. The plasma then filters through human liver cells. "That plasma then bathes these liver cells, and the liver cells perform their function and return purified and detoxified plasma to the patient," Dr. Brown said.

FOR MORE INFORMATION, PLEASE CONTACT:
NewYork-Presbyterian Hospital
Research Office
(212) 305-3839