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Tuesday, 6 April, 1999, 15:25 GMT 16:25 UK
Artificial liver 'could cut organ waits'
The artificial liver could reduce the organ transplant waiting list
The world's first artificial liver to function with cloned human cells could cut organ transplant waiting lists, say doctors.

The University of Chicago Hospital in the US is to begin clinical trials of the liver device, which will function in a similar way to a kidney dialysis machine.

The aim is to keep a damaged liver functioning normally until the patient recovers or a transplant can be undertaken.

Previous temporary devices have used pig cells, but there are concerns that pig diseases could be passed to humans through this method.

Also, the human cell device works on a continuous basis, whereas the pig cell devices function for only six to eight hours a day.

Pig cells

Dr Michael Millis, director of the liver transplant programme at the University of Chicago Hospital, said: "Several previous devices containing liver cells from pigs have produced encouraging results.

"But there has been a good deal of concern about exposing patients to animal cells, which may function slightly differently and could harbour infectious agents.

"This trial should determine whether a device that incorporates human rather than pig-liver cells can reduce those risks and perhaps function more like a normal human organ."

The 24 patients involved in the trial will all have developed a condition known as fulminant hepatic failure (FHF).

This rapidly progressive condition usually affects young, healthy people and can lead to jaundice, fatigue, coma and death.

Often the cause is unknown, but viral liver infections and exposure to some toxic chemicals or drugs like acetaminophen can be a factor.

The artificial liver will protect the brain and other organs for up to 10 days. This allows the real liver time to recover so that transplantation can be avoided.

Research shows that up to two thirds of people whose FHF is caused by acetaminophen have recovered without the need for transplantation.

Donor shortage

The artificial liver could also mean the patients' organs are protected during the wait for a suitable organ.

Because of a shortage of organ donors, patients often face a long wait for a transplant.

Doctors in the UK have warned of a transplant crisis.

Last year the waiting list for a liver transplant rose by 12% on the previous year.

Some 201 people were waiting for a transplant at the end of the year.

Patients with acute liver failure can have only hours to live and may be in more urgent need of a transplant than patients requiring kidney, lung or heart transplants.

In the US, more than 12,000 people are waiting for a liver transplant while fewer than 4,500 usable livers are donated a year.

In 1997, more than 1,000 US patients died while waiting for a liver transplant.

The artificial liver may also be able to help support the patient after transplantation, until the graft takes hold.

Professor Millis says the device, developed by VitaGen, could reduce the number of people on the waiting list by giving people time to recover from acute liver infections spontaneously.

The artificial livers are portable and comprise cartridges filled with immortalised liver cells which can be placed in a standard kidney dialysis machine.

They are attached to blood vessels in the groin and work by separating the plasma from the other parts of the blood and pumping the plasma through the filter cartridges.

The treated plasma is then filtered, remixed with other parts of the blood and returned to the patient.

Range of advances

John Evans of the British Organ Donor Society (BODY) said the device was "marvellous news" if it worked.

He added that it was just one of a range of advances in liver disease treatment.

For example, US doctors have successfully treated patients with a temporary pig's liver which remains outside the human body.

BODY supports the use of pig cells and organs for treating liver disease, saying it is confident they would be used only if they passed rigorous safety tests.

Dr Michael Millis on the new artificial liver device
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