FDA Testing Artificial Liver 146
NIckGorton writes "Research is now underway in the US to seek FDA approval for an artificial liver. The Extracorporeal Liver Assist Device (ELAD) filters blood through a cartridge containing immortalized human liver cells with fiber tubes running through that allow the patients blood to interact with them. This allows the matrix of liver cells to perform both the metabolic (cleansing the blood of toxins/waste) and synthetic (producing albumin, clotting factors, etc) functions of the patient's failing liver. A small trial in China showed a statistically and clinically significant difference in 30 day survival with ELAD."
Hello, Eh, Can we have your Liver? (Score:5, Funny)
"Don't worry, there's nobody who's had their Liver taken out by Us who's survived."
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This is great. I can start drinking again!
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I hear ya, first thing I thought of!!
I live in New Orleans, where drinking is part of the way of life here. I used to never have a problem with hangovers, till about 2 years ago...when I first discovered what one REALLY was. And in he past year, after only 4-5 beers, I can be laid up with a hang over for next day. I joking tell people I think I blew a liver last year....
Nice to know they may have a back up for me in a few years...
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Ha ha, very funny! My chemo, for liver disease caused by blood products that were gathered at Arkansas, and later, Louisiana prison systems, comes to an end in two weeks (then follow-up). Those blood products cleared the FDA, despite not having been tested for hepatitis and HIV. Tests which were in existence for at least several years at that point. Connaught Labs. Blood is a billion dollar business, and nothing is as crucial to living as the func
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FDA protections? How about the restrictions on stem cell research. Add the people who could have benefitted, but died because of the technology delay, to the list of GW Bush's victims.
wrong cit (Score:2)
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Human stem cells weren't even discovered until 1998, and in response President Clinton's administration recommended to allow funding for some embryo experimentation. It wasn't until 2001 that the ethics process concluded and the ruling was issued. That was the ruling that GW Bush acted on, way back in 2001.
And then GW Bush sat there. Science advanced, and he did nothing to advance policy along with the science.
Don't make apologies for Bush. He cannot be defended.
Yum (Score:1, Funny)
Now if we could just get some artificial onions to go with that...
Re:Yum (Score:5, Funny)
I was feeling more like fava beans, and maybe a nice chianti.
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I was feeling more like fava beans, and maybe a nice chianti.
Infact at first glance, I thought it said "FDA Tasting....". Funny And btw, why are they testing in China?
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It might have something to do with the fact that so many millions of people in China have liver diseases. The estimate on just Hepatitis B is around 130 million. A lot of traditional Chinese medicine revolves around liver treatments, probably because "as goes the liver, so goes the rest." So there's a huge population to use in the understanding of all sorts of issues related to liver function.
Hepatitis C was first isolated in the late 70s, I think. The first test for
Re:Yum (Score:4, Funny)
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Ketchup. LOTS of ketchup. Anything to hide the taste.
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Do they have any idea what this will do to the liver and onion market on Reticula?
Immortalized? (Score:4, Funny)
Imagine... (Score:2, Funny)
Just imagine... a beowulf cluster of cancer cells! Woo!
Until they test... (Score:1, Insightful)
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You will be. You will be.
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You will be. You will be.
Probably. I had the peanut sauce at the Thai place for lunch.
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How is that different from any other Wednesday?
Very different.
Today's Thursday. ;)
IMMORTAL! (Score:4, Interesting)
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I for one, and this might just be my superstitious self, would be concerned about the prospect of my bodily fluids interacting with biological material that has been, so to speak, "immortalized."
Ah, so you're saying you are an atheist?
"It am who am...the liver!"
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Re:IMMORTAL! (Score:4, Interesting)
immortalized cells aren't just for cancer and vampires, your stem cells are also effectively immortal as well.
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Well, at least until the body that those stem cells live in dies, that is...
Re:IMMORTAL! (Score:5, Funny)
Side effects may include nausea, dizziness, dry mouth, and the tendency to transform into a zombie when exposed to the light of the full moon.
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Are you sure you didn't mean to type "precious bodily fluids?" [wikipedia.org]
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I for one, and this might just be my superstitious self, would be concerned about the prospect of my bodily fluids interacting with biological material that has been, so to speak, "immortalized."
Huh - slashdotters are so supernatural-minded.
What they actually do is get the surviving Beatles to re-form and compose a number 1 hit song about liver cells, hire a Nobel laureate to write a book about them and hang a picture of the donor liver in the Louvre.
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Best comment in this thread!
An artificial liver? (Score:5, Funny)
I'll drink to that!
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Sweet! (Score:2, Insightful)
Waiting for its most stringent test! (Score:2)
Spring Break
Immortal liver cells want BLOOD! (Score:4, Interesting)
Re:Immortal liver cells want BLOOD! (Score:5, Informative)
Cell immortality is orthogonal to the abnormal replication present in cancerous cells. There are lots of cells in your body which are effectively immortal but do not undergo abnormal replication, and are therefore not cancerous. [Obvious examples are your spermatogonia and progenitor cells in your bone marrow.]
As far as immune cells go, so long as you've avoided including proliferative immune cells, you should be free from graft vs host issues. Growing the hepatocytes from cell lines that have been sorted pretty much guarantees this.
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Yes, but the immortal liver cells in this device could very well be cancerous. Isn't the most common method for immortalizing cell lines in the lab to fuse the desired cell with cancer cells to form an immortal hybrid (selecting for the hybrids by both immortality and a genetic marker)?
I think that great care would need to be taken to make sure that the cells never leak into your blood stream. That shouldn't be too hard with the right engineering, but there certainly is some cause for concern.
Re:Immortal liver cells want BLOOD! (Score:4, Informative)
Sure, but they don't have to be. (Car analogy: Ferrari's are often red, but they don't have to be.)
Not really. What you're talking about is a hybridoma, which is generally used in the formation of monoclonal antibodies. As far as what method is actually used to produce the line, it really depends on what you want a cell line for. (Cell lines are immortal by definition, by the way; they don't get immortalized.)
Most common cell lines are actually just isolated from various kinds of tumors, though.
Re:Immortal liver cells want BLOOD! (Score:5, Informative)
Use of these cancer cells in an artificial liver does create the risk of transfer to the patient, but the cells in question will be suspended in a collagen matrix, and is kept separate from the blood by a dialysis-type semipermeable membrane. Contracting cancer from this device requires that the dialysis membrane fail, that cancer cells get out of the collagen and into the filtrate, that the cancer cells are not caught by the dual membrane cell filter, and that once in the body, a cancer cell from a line noted for low tumorigenic potential implants somewhere and begins to form a tumor. Not impossible, but it is unlikely.
Re:Immortal liver cells want BLOOD! (Score:5, Insightful)
Also very important to note is that anyone who is getting this treatment is going to be seriously ill to begin with, and without it will be dying. I'm sure that they'll consider a chance of getting cancer is a small price to pay.
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And of course, if it really means the difference between life and death, that tiny risk is certainly worth it.
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In addition, the liver is composed of cells that are almost certainly incompatible with the patient ; any stray cells that manage to get through all those formidable layers of physical protection are going to be mercilessly exterminated by even the weakest immune system.
This is the reason for keeping the liver separate from the patient behind a dialysing membrane in the first place - otherwise their immune system will kill it in very short order.
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Cancer cells that aren't the patients cells are highly, highly unlikely to result in a cancerous growth unless a patient is highly immunocompromised. An even marginal functional immune system can recognize cells that are not of the host organism and attack them. The reason cancer is dangerous is that the cells are your own and thus the immune system doesn't recognize them as "other" and attack them.
Thus the fact that cancer, in general, is not contagious. There are certain very rare exceptions that have
Artifical Liver (Score:3, Interesting)
As a two time kidney transplant recipient myself, I know how hard it is to live with organ failure. I met a guy who had gone through 3 liver transplants, and hepatitis had killed all of them. He is all right now,on his fourth transplant, but something like this can make all the difference in the world to people waiting for a liver. Especially since he had two small daughters.
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Makes me wonder about building an artificial heart powered by normal muscle. It would solve the power supply problem.
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The heart IS a muscle... the trick would be building an artificial heart powered by the body's own nervous energy, or somehow replacing the vulnerable cartilage and passageways of the heart with artificial materials. Besides, a lot of heart issues are with the muscle itself, beginning with arrhythmia and the like. Building an artificial muscle that's powered by the existing bodily systems, now there's a trick and a half.
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So who is this guy that he's been pushed to the front of the queue waiting for a liver transplant not just once, but three more times?
According to the United Network for Organ Sharing (UNOS) there are currently more than 17,000 people waiting for a liver transplant in the US. And only 5,300 transplant operations per year (2002 data) are being performed.
If hepatitis has, indeed, destroyed each of the multiple donated organs placed into this bozo, it's time for him to step aside and to give someone else a ch
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Using the word "self-preservation" only means selfishness, you may argue all you like about the 2 daughters, but... here in this world ALL people should be equal. You get 1 chance. Maybe if this guy is a nobel prize winner and is helping advance society at a wonderful rate, where he's saving
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No, he shouldn't technically refuse it, I agree. But he should (keyword, should, but doesn't have to) think of the others, based on the statistics posted above: 11,700 people don't get transplants. What are the odds that person is a child under 18? Although the origi
A question on multi-time transplants. (Score:2)
>As a two time kidney transplant recipient myself, I know how hard it is to
>live with organ failure. I met a guy who had gone through 3 liver transplants
A serious question:
With donation organs being the rarity that I've heard they are, and so many people I've heard are on waiting lists to get them, how does one successfully make the cut for 2 or even 3 organs?
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I heard that some people have rare tissue types that are hard to match. By implication that means others are easier to find a match for?
Then again, statistically there'd be more people with those types waiting for transplants, so it'd cancel out.
Perhaps the GP could enlighten us? Or someone in the business explain how they choose who gets the bits?
Chinese controls (Score:5, Funny)
A small trial in China showed a statistically and clinically significant difference in 30 day survival with ELAD.
So more people with this ELAD liver replacement were alive at 30 days than a control group, who presumably had their livers removed and replaced with nothing...
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a control group, who presumably had their livers removed and replaced with nothing...
It's about time people started doing this research. It's been woefully lacking in the last few decades.
Yeah, ever since Nazi Germany fell, mad science just wasn't what it used to be... *sigh*
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Don't be ridiculous. They use sugar pills.
(Or Folger's crystals!)
"Immortalized"? (Score:4, Insightful)
Nice way of saying "we're replacing your bad liver cancer with a good liver cancer in this handy take-home plug-in box".
Re:"Immortalized"? (Score:5, Interesting)
Ultimately, as we understand more, i believe the mechanisms of cancer will be more harnessed than eliminated.
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My understanding of cancer (IANAO and I may not entirely know what I'm talking about here) is that there is no "mechanism" as such -- it's simply uncontrolled cell growth. Generally it occurs when a cell's genes that limit its growth or cause apoptosis get corrupted.
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You know, if you have 30 days to live because of liver failure, I think getting cancer is worth extending that by a few months...
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You know, if you have 30 days to live because of liver failure, I think getting cancer is worth extending that by a few months...
Here's the thing. You wouldn't actually have cancer if on this device, not unless the barriers between the blood flow and the cultured liver cancer cells allowed these immortalised cells to enter your body and lodge somewhere else. Then, depending on how well your own immune system took care of the invaders, you could be in *real* trouble. If we're talking about something that most people can't reject there could be real problems - especially if it becomes transmissible, as has been observed with certain ca
Immortals (Score:1)
Looks like they found a way to... (Score:2)
...save the liver! [hulu.com]
Plumbing for Struldbrugs (Score:4, Interesting)
There's no information about the interface of this device to the patient. Blood flow to the liver is rather unique (http://biology.about.com/library/organs/bldigestliver.htm [about.com]), with 3/4 of its bloodflow coming from the portal vein and 1/4 from the hepatic artery. The blood mixes before being processed by the liver.
Is the device similarly fed by both arterial and venous sources? How is the pressure compensated? Where is the output reintroduced? Does the device run in parallel to the natural liver or in series? If the latter, which receives the blood first? Does it attempt to handle any of the other numerous functions of the liver such as the creation of bile or lymph?
Re:Plumbing for Struldbrugs (Score:5, Informative)
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For the US market, they're offering a range.... (Score:2, Funny)
The product line itself will vary in capability and price. From the basic "Joe Sixpack" model, you can move up to the "Jazz Musician". If you've got enough money you can go all the way up to the full "Kieth Richards" model.
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Does it prevent you from being killed by mortal weapons, or just any snorted, injected, inhaled, or eaten compound?
A longer term solution... (Score:5, Funny)
I think I'd just ask if they could immortalize all of my body's cells.
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Sure, it's called "cancer".
Some background (Score:5, Interesting)
(Any doctors or biologists more knowledgeable can fill in the gaps and correct me)
The liver breaks down toxins in the blood by metabolizing them. That is, they get broken down into simpler compounds by chemical reactions that take place in and around living cells. Contrast this with dialysis - an artificial kidney - which is able to work by filtering out chemicals based on molecular weight. Dialysis uses bundles of membranes that allow relatively light molecules (such as water) to pass through, but block heavier ones. The stuff the liver breaks down are too unwieldy or complex to be filtered out based just on weight - there are lots of other, good things in the blood that are of similar weight or complexity. A simple filter can't distinguish them; hepatocytes (liver cell clusters) can.
The task of creating the filtering membrane of a dialysis machine is a relatively well understood materials and processing problem. An artificial liver, which usually has a mini dialysis unit on the front or back end, also requires you to have living clusters of cells, and keep them alive, nourished, and healthy long enough for them to do some effective and therapeutic blood filtering. That's a much trickier biological problem, and we are only now getting decent at it.
The uses for a bio-artificial liver is huge. It can help people with chronic liver failure live longer and healthier lives, true, but it has more uses than that. The liver, as it turns out, is one of the few organs that can regenerate itself. If it is damaged by disease or some toxic insult, it is possible for it to repair itself if given the chance (in normally healthy people - the liver can also be damaged beyond repair). The problem is that in lots of cases the patient will die before the liver gets a chance to heal, leaving two options: hope for a liver transplant on really short notice, or die. A device like this can be a bridge to transplant or, in some cases, take the burden off the liver long enough for it to heal itself.
A tutorial on the liver, etc. (Score:5, Informative)
See also the comments above by rlseaman - this will address those as well.
The liver has multiple functions for both biochemical synthesis and detoxification. Unlike most organs and tissues, it has two circulatory inflows. The arterial circulation is the nutritive blood supply, just as the arterial circulation for any tissue. A portal circulation is one in which the venous effluent from a tissue does not return directly to the systemic circulation, but instead detours through another organ first. There are two portal circulations in most chordates - the hypothalamic-pituitary circulation, and the splanchnic portal system. The purpose of the splanchnic portal is to take raw digestate absorbed from the gut, and pass it through a chemical filter (the liver) which will detoxify or eliminate nasty exogenous compounds before they get back into the general circulation (via the hepatic veins). The hepatic artery supplies the liver; the portal vein is the business of the liver. Detoxified products that must be eliminated from the body are excreted into the bile, which is eliminated through the gut. Without a liver at all, death will occur within just a few days, about 3-7.
Renal failure is also lethal, but in the early 1950's, technologies were developed to keep renal failure patients alive - the dialysis machine. Dialysis is used as a bridge to organ transplantation, but for many people it is their permanent replacement kidney. It is an extraordinarily effective device. It could be "perfected" "back then" because the dialysis machine and the kidney are both relatively simple machines when it comes the elimination / detoxification aspects of its function. It depends simply on diffusion across semi-permeable membranes so that chemical concentrations can be equilibrated. No cells nor other active function is needed.
Compare this to heart function. We can transplant hearts quite successfully, but unlike the kidney, we cannot keep people alive without their native heart. Attempts in the past 10-20 years to develop mechanical bridge devices have all been technical, medical, and ethical failures, awaiting some future technologies to make the concept truly feasible.
The liver is in between. With regard to basic medical and ethical issues, an artificial liver should be comparable to the kidney. But technically and scientifically, making an artificial liver has been impossible until recently. Unlike the kidney, emulating liver function cannot be done by simple passive dialysis - the liver has MANY active chemical processes that must be actively metabolized. Attempts to run a patient's blood through a pig liver was the best available technology, and it doesn't work well at all, certainly not long term. What these researchers have done in this article is to mate living human cells to a dialysis device.
From the company's description of the product, it sounds like a fairly standard dialysis cartridge to start with. The key element, something that was NOT technically possible until the biotech revolution that we are now going through, is to put living cells in the device. I presume that the dialysis membranes are much more "porous" than renal dialysis membranes, allowing bigger molecules to get across, but hepatocytes remain sequestered on their side - there is no chance of "mixing and migration". All modern biotech "living cell" products go through ELABORATE testing and purification to get clean single cell lines. "Immortalized" means they have had their genome switched on so that they can mitose and replicate ad infinitum, without reaching the natural limits of mitosis that many differentiated cell lines have. Bile ducts, portal veins, and all that are not needed, because wastes come in through your normal arterio-venous dialysis shunt, and go out in the dialysis effluent. Because the device is not directly siphoning splanchnic blood, the clearance of potential dietary "toxins" is slower, but any patient with advanced liver disease has to make certain dietary adjustments anyway.
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Out of curiosity, what is the great challenge in producing an artificial heart? It would seem to me that sloshing some blood around to a regular rhythm in something blandly neutral to your body would be among the easiest of challenges.
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Three big problems. One: It has to be absolutely reliable and able to run for long periods with refuelling/recharging (and also keep running while it's being refuelled/recharged). It stops, and you only have a few minutes to restore blood circulation. Two: it has to handle the blood gently enough so that it doesn't start clotting; this is not a trivial problem and includes much hard research to formulate the surfacing of all the blood vessels and chambers. Three: It all has to be damn small. This com
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My mother has lived with Cirrhosis of liver for past decade(caused by a bad doctor prescribing painkillers for 6 months instead of proper diagnosis).
This artificial liver could help her IF her body could accept it.
Problem is FDA has a knack of approving stuff before it is really ready for real world. FDA is owned by pharma companies.
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If it is damaged by disease or some toxic insult, it is possible for it to repair itself...
Hey liver, yo' momma's so fat, she's immortal!
Pubs (Score:1)
Clearly the usual joke is how business in the pubs will increase due to this. However, I think there may be some truth to the joke.
Often times those with drinking habits/problems look for excuses as to why it is ok for them to drink. Some use silly rules such as I only drink after 5pm, others say they only binge on the weekends, and others say they are going to die anyway.
Depending on how this is reported, we may begin to see people lower their inhibition, or at a minimum be willing to take more chances wit
Cure for hemophilia... (Score:2, Offtopic)
Currently hemophiliacs must give themselves a shot in order to obtain the factor 8 they need to complete the factor chain and make a clot.
In an extreme accident where a person couldn't be able to give themselves the medicine immediately, the chances for survival drop greatly.
Knowing that they could walk around like a normal person would be a god-send to these people.
Never compete with bacon (Score:2, Funny)
Immortalized (Score:1, Redundant)
immortalized cells? (Score:2)
just asking......
The FDA is NOT testing this... (Score:2, Informative)
The FDA is only a regulatory body...this test is being run by Vital Therapies Inc along with a wide range of hospitals and research organizations
Not the FDA...know the basics...
"Small trial in China" actually means (Score:5, Interesting)
A toast (Score:2)
Christopher Hitchens will be so relieved.
FDA invades China!!! (Score:1)
Ok, seriously, the FDA is using material research from China? Whatever happened to the US doing it's own research?
Say, I wonder if the FDA has contracted human cancer trials in Darfur.
Seriously, human rights anyone?
funding (Score:3, Funny)
Surprisingly, it was revealed that funding for liver replacement research was provided entirely by the liquor industry.
Now the guy at Mickey Mantle's press conference (Score:3, Funny)
who asked the transplant surgeon if the donor was still alive, to which the surgeon replied
"You're a sportswriter, aren't you?"
won't feel like such a roob anymore.
2009... (Score:2)
Wohooo! (Score:2)
Bag-o-Liver (Score:2)
Am I the only one who initially read that as... (Score:2)
FDA testing this? That can only mean... (Score:2)
It's people!!!!!
$30K? (Score:2)
Is this per use or per machine? Can a single machine be refitted and used multiple times ( like a dialysis machine)?
BBH
Immortal liver cells? Delicious. (Score:2)
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We could, but you almost certainly wouldn't like the results. (Well, we most likely could do so theoretically; the ethics board would kill us if we tried.)
Death of cells via apoptosis, phagocytosis and sometimes even necrosis is a very important part of normal processes in your body. WIthout them you'd be a continuously expanding ball of flesh (assuming you even made it to a stage of embryogenesis that could be ca
Sweet! (Score:2)
Without them you'd be a continuously expanding ball of flesh...
Isn't that the American Dream?
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s/dream/reality/
Force feed it a few days. See how it tastes. (Score:2)
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Probably like pig liver. Has anyone in the FDA, um, tested it?