The Future of the Artificial Liver

It is the current consensus in the field that organ transplantation is the primary treatment for chronic liver disease. Throughout the country, there is a significant shortage of organ donors. Not only are there not enough livers, but the surgery itself is traumatic and these individuals must live on auto immune suppressants for the rest of their lives. Taken as a whole, the present solution is incredibly expensive with a low success rate and only helps a small number of people affected with liver disease. However, recent research into artificial livers shows many promising developments.

Over the past two decades, researchers around the world have made significant progress in the creation of a functioning artificial liver. In particular, there have been many successes in engineering artificially grown liver cells that replicate the liver’s functions with designs functioning both inside and outside of the body. The extracorporeal liver assist device, or ELAD, is one such achievement. Connecting this machine to individuals with liver failure has allowed many individuals to survive long enough until an organ becomes available and has even been successful in treating acute liver failure . It also provides extra support to the liver, giving the organ time to regenerate itself. As ELAD undergoes more clinical trials, an increasing number of hospitals across the United States are beginning to offer it as a therapy for liver disease patients.

At BioEngine, a rising firm in biotechnology, researchers created a similar device designed to function within the human body. This structure would theoretically provide a bioartificial scaffold for human liver cells to grow and function normally. In other aspects of the field, biologists have been able to grow artificial liver cells from embryonic stem cells, human hepatocytes, and porcine hepatocytes. Although these technological advances are large steps towards developing a solution to liver failure, scientists still have a long way to go, as there are many biological, ethical, and economic reasons that are hindering artificial liver development.

The creation of efficient human liver cells requires a large amount of time, money, and resources, which adds to the overall costs of these therapies for a small yield of available cells. As a result, many of these therapies are not economically sound and cannot be available to the general public. Many scientists believe that developing more cost effective designs will be the focus of artificial liver research over the next decade. There is already an ongoing public debate on the ethical issues of using embryonic stem cells for research. This dialogue has restricted research in this area, which hopefully will be lifted under President Obama’s administration. From a biological point of view, there are concerns of porcine cells possibly transferring viruses from pigs to humans. Addressing these concerns in these current technologies will allow for further progress within artificial liver research.

A combination of regenerative medicine and stem cells appear to be the most viable method of creating an artificial liver. Within the next ten years, we believe ELAD will be a more accessible treatment for acute liver failure. Similar to the dialysis for acute kidney failure, the ELAD is the most feasible option in order to provide short-term immediate care for the general public. Healthcare reform will be important in whether or not this technology will be affordable for more people. We think that with the reform offering universal insurance to cover more people, the technology will hopefully not be limited to certain socioeconomic classes. Our long term hope is that an artificial liver may be developed from stem cell research harnessing the body’s natural structure to provide a less invasive and more permanent cure to liver disease.

-John, Robin, Mark, and Andrea (Team Artificial Liver)