Seminar: Artificial Liber (Dr. Nathan Davies)

Artificial liver: development of extracorporeal systems to support failing organs Seminar led by Dr. Nathan Davies, Senior Investigator University College of London (UCL). Content: The incidence of liver disease is increasing worldwide and about 1 million patients die from liver failure each year. In liver failure, the accumulation of protein bound toxins and increased susceptibility to infection cause multi-organ failure and death. Apart from liver transplantation, there is no treatment known to prolong the life of these patients. A cost-effective and clinically efficacious 'liver support device' is an unmet clinical need. We have developed and tested a novel 'liver support device' (UCL-ARSeNEL) that could be used on a similar basis to that of a kidney dialysis machine. The concept of the novel device evolved at UCL and is based upon the two discoveries: 1. that albumin, a major molecule involved in the detoxification process, is reduced irreversibly both in concentration and functional capacity (determined using electron paramagnetic resonance spi-label studies) and, 2. that endotoxaemia, which is know to increase as a consequence of liver disease, contributes to increased risk of infection by inappropriately activating the host immune system. The new system device incorporates albumin removal and replacement and, endotoxin removal. The initial studies have provided proof-of concept information, following which we plan to take the project through to a first in man study.