Liver support system

Liver support system

A liver support system is a medical device or therapy designed to assist or replace the function of a failing liver. These systems are crucial in the management of patients with acute liver failure or chronic liver disease awaiting liver transplantation. Liver support systems can be broadly categorized into artificial and bioartificial systems.

Types of Liver Support Systems

Artificial Liver Support Systems

Artificial liver support systems are mechanical devices that perform some of the liver's functions. These systems include:

• Molecular Adsorbent Recirculating System (MARS): A dialysis-based system that removes toxins from the blood.
• Prometheus: A system that combines albumin dialysis with high-flux hemodialysis to detoxify the blood.

Bioartificial Liver Support Systems

Bioartificial liver support systems incorporate living cells to perform the liver's metabolic and synthetic functions. These systems include:

• HepatAssist: A system that uses porcine hepatocytes to provide liver function.
• ELAD (Extracorporeal Liver Assist Device): A system that uses human liver-derived cells to support liver function.

Indications

Liver support systems are indicated for patients with:

• Acute liver failure
• Chronic liver disease with acute decompensation
• Hepatic encephalopathy
• Sepsis-induced liver dysfunction
• Bridging to liver transplantation

Mechanism of Action

Liver support systems work by:

• Removing toxins such as ammonia, bilirubin, and bile acids from the blood.
• Providing synthetic functions such as albumin production.
• Supporting metabolic functions including urea cycle and gluconeogenesis.

Clinical Outcomes

The use of liver support systems has shown to improve:

• Survival rates in patients with acute liver failure.
• Quality of life in patients with chronic liver disease.
• Neurological function in patients with hepatic encephalopathy.

Limitations

Despite their benefits, liver support systems have limitations, including:

• High cost
• Limited availability
• Risk of infection and other complications
• Variable efficacy depending on the underlying liver condition

Future Directions

Research is ongoing to improve the efficacy and accessibility of liver support systems. Future directions include:

• Development of more efficient bioartificial systems using stem cells.
• Integration of nanotechnology for better toxin removal.
• Personalized medicine approaches to tailor liver support therapy to individual patient needs.

See Also

• Liver transplantation
• Hepatology
• Liver disease
• Dialysis