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Erro E, Bundy J, Massie I, Chalmers SA, Gautier A, Gerontas S, Hoare M, Sharratt P, Choudhury S, Lubowiecki M, Llewellyn I, Legallais C, Fuller B, Hodgson H, Selden C. Bioengineering the liver: scale-up and cool chain delivery of the liver cell biomass for clinical targeting in a bioartificial liver support system. Biores Open Access 2013; 2:1-11. [PMID: 23514704 PMCID: PMC3569957 DOI: 10.1089/biores.2012.0286] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Acute liver failure has a high mortality unless patients receive a liver transplant; however, there are insufficient donor organs to meet the clinical need. The liver may rapidly recover from acute injury by hepatic cell regeneration given time. A bioartificial liver machine can provide temporary liver support to enable such regeneration to occur. We developed a bioartificial liver machine using human-derived liver cells encapsulated in alginate, cultured in a fluidized bed bioreactor to a level of function suitable for clinical use (performance competence). HepG2 cells were encapsulated in alginate using a JetCutter to produce ∼500 μm spherical beads containing cells at ∼1.75 million cells/mL beads. Within the beads, encapsulated cells proliferated to form compact cell spheroids (AELS) with good cell-to-cell contact and cell function, that were analyzed functionally and by gene expression at mRNA and protein levels. We established a methodology to enable a ∼34-fold increase in cell density within the AELS over 11-13 days, maintaining cell viability. Optimized nutrient and oxygen provision were numerically modeled and tested experimentally, achieving a cell density at harvest of >45 million cells/mL beads; >5×10(10) cells were produced in 1100 mL of beads. This process is scalable to human size ([0.7-1]×10(11)). A short-term storage protocol at ambient temperature was established, enabling transport from laboratory to bedside over 48 h, appropriate for clinical translation of a manufactured bioartificial liver machine.
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Affiliation(s)
- Eloy Erro
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - James Bundy
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Isobel Massie
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Sherri-Ann Chalmers
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Aude Gautier
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Spyridon Gerontas
- The Advanced Center for Biochemical Engineering, Department of Biochemical Engineering; University College London, London, United Kingdom
| | - Mike Hoare
- The Advanced Center for Biochemical Engineering, Department of Biochemical Engineering; University College London, London, United Kingdom
| | - Peter Sharratt
- PNAC Facility, Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Choudhury
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Marcin Lubowiecki
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Ian Llewellyn
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Cécile Legallais
- CNRS UMR 6600 Biomechanics and Bioengineering, University of Technology of Compiègne, Compiègne, France
| | - Barry Fuller
- Cell, Tissue & Organ Preservation Unit, University Department of Surgery, UCL Medical School, Royal Free Hospital Campus, London, United Kingdom
| | - Humphrey Hodgson
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
| | - Clare Selden
- Liver Group, UCL Institute of Liver & Digestive Health, London, United Kingdom
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Tylman M, Bengtson JP, Bengtsson A. Activation of the complement system by different autologous transfusion devices: an in vitro study. Transfusion 2003; 43:395-9. [PMID: 12675727 DOI: 10.1046/j.1537-2995.2003.00311.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of the present investigation was to study whether autologous transfusion devices activate the complement system and whether complement-activated blood is more vulnerable to further activation during processing. STUDY DESIGN AND METHODS Forty-eight blood units were randomized to be processed by one of three different salvage systems: Group 1 underwent whole blood filtration (hemofiltration) (n=16); Group 2 underwent continuous processing, saline washing, and centrifugation (CATS, Fresenius AG ) (n=16); and Group 3 underwent saline washing and centrifugation (Cell-Saver, Haemonetics Corp.) (n=16). Eight blood units for each system were activated with cobra venom factor (CVF) at a concentration of 0.2 U per mL whole blood before processing. C activation was studied by determinations of C4d, Bb, C3a, and SC5b-9. Samples were drawn from whole blood, processed blood, and the waste bags. RESULTS The concentrations of Bb, C3a, and SC5b-9 in whole blood after activation with CVF were significantly elevated compared to blood that was not activated (p < 0.01). Processed blood from hemofiltration contained significantly higher levels of complement-split products than techniques that use washing and centrifugation. The concentrations of SC5b-9 in blood processed by hemofiltration were higher in the experiments with CVF activation (p < 0.05). CONCLUSION The tested autologous transfusion systems did not themselves activate the complement system, and complement-activated blood was not more vulnerable to further activation during processing. A blood-salvaging technique that used washing and centrifugation reduced elevated concentrations of complement-split products, whereas hemofiltration did not.
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Affiliation(s)
- Maria Tylman
- Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital/Ostra, Göteburg, Sweden.
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Fukunaga K, Shimoyama T, Sawada K, Mueller J, Sueoka A, Nosé Y. In vitro evaluation study of the membrane autotransfusion system experimental prototype: MATS-I. Artif Organs 2000; 24:95-102. [PMID: 10718761 DOI: 10.1046/j.1525-1594.2000.06428.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Membrane Autotransfusion System (MATS) utilizing plasmapheresis technology has been developed in our laboratory. A specially designed polyethylene hollow fiber membrane was utilized. This study was conducted to evaluate performance of the first experimental prototype, MATS-I. The results of this study showed that the MATS-I could concentrate diluted blood at 10% of the initial hematocrit concentration (HCTi) into over 40% after passing through the system at a transmembrane pressure of 70 mm Hg. Moreover, the MATS-I can continuously treat 10,000 ml of diluted blood at various HCTi levels without deteriorating its performances. Even though the MATS-I met all required performances as an autotransfusion system, several areas of improvement of the system were necessary to meet various clinical needs. The next prototype, MATS-II, can be designed based on experiences obtained from the MATS-I. The MATS is smaller, more atraumatic and continuous, and is a faster system when compared to the currently available centrifugal autotransfusion devices.
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Affiliation(s)
- K Fukunaga
- Department of Internal Medicine IV, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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