Hepatic support with hepatocyte suspensions in a permeable membrane dialyzer

Abstract

Hepatic support by whole liver, liver slice, or hepatocyte perfusion is unsatisfactory. A new concept of support with circulating hepatocytes on one side of a cuprophan membrane and blood from an anhepatic pig on the other was evaluated in 19 dialysis experiments. Levels of pyruvate metabolism and oxygen utilization were similar to those obtained when liver cells in a centrifuge are perfused with oxygenated plasma. Of six anhepatic pigs given late hepatic support, five showed neurologic improvement. One had concomitant improvement in electroencephalographic results. A membrane hemodiolysis unit in which hepatocytes circulate against blood from an anhepatic animal is the most suitable extracorporeal liver support unit described so far. Its simplicity allows repeated and prolonged use.