Primary clinical study of a novel bioartificial liver combined with liver transplantation in patients with liver failure / 中华器官移植杂志

ABSTRACT

Objective To investigate the safety and therapeutic effects of the novel bioartificial liver (BAL) combined with liver transplantation in patients with liver failure.Method Twenty-two patients with liver failure were admitted.Ten of them were treated with the novel BAL 24 h before liver transplantation,while the rest 12 served as controls and received liver transplantation only.The clinical signs and symptoms,liver function,ammonia,coagulation function and complete blood count were evaluated before,during and after the treatment.Levels of xenoantibodies (IgG and IgM) were detected by ELISA kit.Titers of complement were quantified by CH50 kit.DNA in the collected PBMCs was extracted for PCR with PERV specific primers and the porcine specific primer Sus scrofa cytochrome B.The RT activity was detected as well.The operation related information was recorded,such as operation success rate,operative time,cold ischemia time,bleeding volume in operation and liver function.Result All treatment procedures were completed successfully without any adverse reaction.In the BAL group,the clinical symptoms such as acratia,anorexia and abdominal distension were improved,as well as the stage of hepatic encephalopathy and the results of experimental tests such as liver function,ammonia,and coagulation function.No PERV infection and no obvious changes of the IgG,IgM and CH50 levels were detected in patients plasma.All patients were successfully bridged to modified pig-back liver transplantation and recovered.There were no differences in operative time and cold ischemia time (P＞0.05).However,bleeding volume was different in these two groups (P＜0.05).The liver function was improved significantly in BAL group than the control group after liver transplantation (P＜0.01).Conclusion The novel BAL could improve the internal environment of patients with liver failure,and enhance the safety and efficiency of liver transplantation.The novel BAL combined with liver transplantation could be an effective therapy for patients with liver failure.