Preclinical Experience of the Mayo Spheroid Reservoir Bioartificial Liver (SRBAL) in Management of Acute Liver Failure

GND
1102166227
ORCID
0000-0001-7399-8383
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Felgendreff, Philipp;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Tharwat, Mohammad;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Hosseiniasl, Seyed M.;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Amiot, Bruce P.;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Minshew, Anna;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Rmilah, Anan A. Abu;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Sun, Xiaoye;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Duffy, Dustin;
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Kremers, Walter K.;
ORCID
0000-0002-5005-3050
Affiliation
Department of Surgery, Mayo Clinic, Rochester, MN 55902, USA
Nyberg, Scott L.

The Spheroid Reservoir Bioartificial Liver (SRBAL) is an innovative treatment option for acute liver failure (ALF). This extracorporeal support device, which provides detoxification and other liver functions using high-density culture of porcine hepatocyte spheroids, has been reported in three randomized large animal studies. A meta-analysis of these three preclinical studies was performed to establish efficacy of SRBAL treatment in terms of survival benefit and neuroprotective effect. The studies included two hepatotoxic drug models of ALF (D-galactosamine, α-amanitin/lipopolysaccharide) or a liver resection model (85% hepatectomy) in pigs or monkeys. The SRBAL treatment was started in three different settings starting at 12 h, 24 h or 48 h after induction of ALF; comparisons were made with two similar control groups in each model. SRBAL therapy was associated with significant survival and neuroprotective benefits in all three animal models of ALF. The benefits of therapy were dose dependent with the most effective configuration of SRBAL being continuous treatment of 24 h duration and dose of 200 g of porcine hepatic spheroids. Future clinical testing of SRBAL in patients with ALF appears warranted.

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