Medical artificial liver

In terms of membrane area used and dollar value of the membrane produced, artificial kidneys are the single largest application of membranes. Similar hollow-fiber devices are being explored for other medical uses, including an artificial pancreas, in which islets of Langerhans supply insulin to diabetic patients, or an artificial liver, in which adsorbent materials remove bilirubin and other toxins. 

The main artificial liver devices that are presently under study include Molecular Adsorbent Recirculating System (MARS, Gambro Lundia, Lund, Sweden), Prometheus (Fresenius Medical Care, Bad Homburg, Germany), and Liver Dialysis (HemoCleanse, Lafayette, Indiana, USA). 

There are artificial liver support devices available commercially with some evidence of efficacy with regard to secondary outcomes, such as improvements in encephalopathy and nephropathy, but no single device has clearly demonstrated convincing improvements in survival. Bioartificial liver systems continue to offer promise but are still in clinical trials. Systematic reviews combining the outcomes from several support devices have suggested reductions in mortality in AOCLF when compared to standard medical therapy, but a recent review evaluating more modern support devices found a benefit only in ALF. A number of large, multicenter randomized studies are currently underway. 

Artificial glycopolymers having a-galactosyl epitope are of interest from the viewpoint of medical transplantation of pig liver since they can block im-... 

Also mentioned in the aforecited book are colchicine and colchidnamide, derived from the common autumn crocus (Colchicum autumnale), also called meadow saffron. (Colchicine, incidentally, is used in plant gaieties to artificially produce mutations.) The notable use cited is against breast cancer, but gout and arthritis also yield to treatment. It is emphasized that both these alkaloids are potent, and their use requires expert medical supervision. Another plant mentioned is cro-talaria (Crotalaria spectabilis), from which a toxic alkaloid called monocrotaline may be obtained. This substance also has antitumor properties, but acts against the liver. 

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