Basic Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2017; 23(18): 3262-3268
Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3262
Artificial liver support in pigs with acetaminophen-induced acute liver failure
Guo-Lin He, Lei Feng, Lei Cai, Chen-Jie Zhou, Yuan Cheng, Ze-Sheng Jiang, Ming-Xin Pan, Yi Gao
Guo-Lin He, Lei Feng, Lei Cai, Chen-Jie Zhou, Yuan Cheng, Ze-Sheng Jiang, Ming-Xin Pan, Yi Gao, Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
Author contributions: Pan MX and Gao Y designed the research; He GL, Zhou CJ, Cheng Y, Jiang ZS and Gao Y performed the research; He GL, Zhou CJ and Cheng Y analyzed the data; He GL wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Zhujiang Hospital Institutional Review Board.
Institutional animal care and use committee statement: All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee of Guangdong Province [IACUC protocol number: SCXK (Guangdong) 2011-0015].
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Yi Gao, Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, No. 253 Gongye Road, Haizhu District, Guangdong Province, Guangzhou 510280, Guangdong Province, China. gaoyizjyy@126.com
Telephone: +86-20-62782560 Fax: +86-20-61643207
Received: December 6, 2016
Peer-review started: December 6, 2016
First decision: December 29, 2016
Revised: January 24, 2017
Accepted: March 20, 2017
Article in press: March 20, 2017
Published online: May 14, 2017
Abstract
AIM

To establish a reversible porcine model of acute liver failure (ALF) and treat it with an artificial liver system.

METHODS

Sixteen pigs weighing 30-35 kg were chosen and administered with acetaminophen (APAP) to induce ALF. ALF pigs were then randomly assigned to either an experimental group (n = 11), in which a treatment procedure was performed, or a control group (n = 5). Treatment was started 20 h after APAP administration and continued for 8 h. Clinical manifestations of all animals, including liver and kidney functions, serum biochemical parameters and survival times were analyzed.

RESULTS

Twenty hours after APAP administration, the levels of serum aspartate aminotransferase, total bilirubin, creatinine and ammonia were significantly increased, while albumin levels were decreased (P < 0.05). Prothrombin time was found to be extended with progression of ALF. After continuous treatment for 8 h (at 28 h), aspartate aminotransferase, total bilirubin, creatinine, and ammonia showed a decrease in comparison with the control group (P < 0.05). A cross-section of livers revealed signs of vacuolar degeneration, nuclear fragmentation and dissolution. Concerning survival, porcine models in the treatment group survived for longer times with artificial liver system treatment (P < 0.05).

CONCLUSION

This model is reproducible and allows for quantitative evaluation of new liver systems, such as a bioartificial liver. The artificial liver system (ZHJ-3) is safe and effective for the APAP-induced porcine ALF model.

Keywords: Hepatic failure, Acetaminophen, Artificial liver, Acute liver failure, Liver-assisted device

Core tip: This is an article about an artificial liver system that was used to treat an acetaminophen (APAP)-induced porcine acute liver failure (ALF) model. An APAP porcine ALF model was developed and treated with an artificial liver system. The artificial liver system (ZHJ-3) improved serum biochemistry levels and extended porcine survival times significantly. This study concluded that the APAP-induced model is reproducible and allows for quantitative evaluation of new liver systems, such as a bioartificial liver, for the support of hepatic failure in humans. The artificial liver system (ZHJ-3) is safe and effective for the APAP-induced porcine ALF model.