Review: Hepatocyte Transplantation: A Potential Treatment for Acute Liver Failure

Abstract

Acute or fulminant liver failure (ALF) still constitutes a major cause of morbidity and death in patients with liver disease. Various potential treatments have been discussed, to reduce ALF-induced deaths. Liver transplantation has been suggested as the most effective means for treating fulminant and subacute hepatic failure, irreversible liver disease, selected hepatic diseases of metabolic deficiency, and end-stage chronic liver disease (1-5). However, numerous problems are still to be solved in orthotopic liver transplantation, such as a critical donor shortage and preservation problems as a result of increasing demands for liver transplants, and a still substantial morbidity and death associated with the transplantation procedure. Primary graft dysfunction after liver transplantation is quite common, and the most severe form occurs in 2-12% of transplanted cases, responsible for some of the posttransplantation morbidity and deaths, even when early retransplantation is performed (6,7). Infectious complications are among those most commonly encountered, contributing to death after liver transplantation (8-10). Although heterotopic (auxiliary) partial liver transplantation has been reported as sufficient in metabolic or end-stage chronic liver disease (11,12), the same clinical problems are to be expected as after total liver transplantation. Another problem is that many patients with liver failure cannot tolerate the transplantation owing to concomitant infection, metabolic cachexia, alcoholism, age, cachexia, or other associated organ failures (13).