Cell-based clinical and experimental methods for assisting the function of impaired livers – Present and future of liver support systems

Abstract

Currently, one of the most serious public health issues is the increasing number of cases of chronic liver disease and cirrhosis both of which can lead to liver failure. The only effective method of treatment for this life-threatening condition remains liver transplantation. Unfortunately, the chronic shortage of transplantable organs seriously limits its accessibility to patients. Thus, tremendous research has been done to develop methods capable of replacing liver transplantation by artificial means or to create techniques to partially or fully replace liver function in patients with impaired livers, until liver regeneration or transplantation. This review article is focused on research results that utilize living cells in order to establish bridging therapies in cases of liver failure. This includes both experimental and clinically tested techniques, such as hepatocyte transplantation and usage of the hybrid bioartificial liver devices. The article also discusses research which presents the long-term culture of hepatocytes in conditions that preserve their differentiated state, which is important for such applications as drug development and toxicity testing. Last but not least, the article describes the groundbreaking efforts toward building sophisticated scaffolds for hepatocyte culture that mimic their natural environment, which are based on decellularized tissues and on three-dimensional bioprinting.