Patients with advanced liver diseases have very high mortality due to associated complications such as hepatic encephalopathy (HE), hepato-renal syndrome (HRS) and multi-organ failure (MOF). Liver transplant is the only therapeutic option for such patients; however, a problem linked to its availability, cost, complications and side effects delimits its practical application. Strong potential for hepatic regeneration and recovery could be documented in liver diseases without advance decomposition of the liver. Recently hepatocytes transplantation is used as an alternative to liver transplantation, but insufficient numbers of functional hepatocytes for therapeutic efficacy limits its practical applications. In addition uses of extracorporeal liver support systems are used as a modality for liver patient management or to bridge them to a possible liver transplant. But this system lacks a clear-cut survival benefit specifically in advance liver disease. Further due to limited numbers of donor organ donations or living donor liver transplantation (LDLT) across the globe many novel technologies have been proposed which cater to the development of a three dimensional composite constructs, 3D perfused bioreactors for spheroid culture, liver-on-a-chip platforms and bio-printed liver to produce an implantable in vitro liver which may reliably predict the in vivo–like tissue responses and could also be suitable for drug toxicity testing. This review focuses on the novel technologies that are now used for liver regeneration and production of a transplantable liver.
Shivaji Kashte, D Y Patil University, Kolhapur 416006, India
Jaswinder Singh Maras, Institute of Liver and Biliary Science, D-1, VasantKunj, New Delhi, Delhi 110070, India
Sachin Kadam, Advancells, A102, Sector 5, Noida, UP 201301, India and D Y Patil University, Kolhapur 416006, India
Journal: Critical Reviews™ in Biomedical Engineering