在无法进行肝移植的情况下,肝衰竭的发病率和死亡率均较高.人工肝支持系统,特别是生物人工肝,则可促进肝衰竭恢复或作为肝移植的过渡辅助.生物人工肝中含肝细胞的生物反应器可提供生物转化和肝脏的合成功能.所使用的肝细胞既可以为人肝细胞也可以为异种肝细胞(动物源性).病人的血液或血浆循环通过生物反应器,由肝细胞代谢去除毒素并产生所需化学成分后,再返回病人体内.随着人类及猪肝细胞长期培养增殖的成功,以及具有充分生物相容性的微载体的发展,单位体积内培养肝细胞的密度在当前已经可以满足生物人工肝系统的需要.以生长在微载体上的肝细胞填充而成的中空纤维生物反应器已得到广泛使用,在不久的将来,生物人工肝支持系统成为肝衰竭治疗的有效方法具有良好前景.
Liver failure without transplantation is associated with high morbidity and mortality.Artificial liver support systems,particularly bioartificial livers,are one possible solution for bridging the time to transplantation and/or recovery from liver failure.Bioartificial livers comprise bioreactors containing hepatocytes,and provide both biotransformation and synthetic liver functions.The hepatocytes can be either allogeneic or xenogeneic(animal origin).The patient's blood or plasma circulates through the bioreactors and is returned to the patient after toxic compounds have been cleared and synthesized products added by the hepatocytes.The successful long-term propagation and culture of both human and pig hepatocytes and the development of adequate biocompatible microcarrier modules means that it is now possible to achieve sufficient hepatocyte density per unit volume to develop bioartificial liver systems.Hollow-fiber bioreactors filled with hepatocytes growing on microcarriers are widely used.The development of a bioartifical liver support system is a particularly appealing and pragmatic approach to the future treatment of liver failure.