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Artificial liver using human cells keeps Illinois woman alive until organ found for transplant.

A new type of artificial liver that uses human cells successfully kept a woman in fulminant liver failure alive until a transplant organ became available.

Sheryl Orlyk, 34, a mother of 3 from suburban Chicago, Ill, was the first to use the extracorporeal liver assist device (ELAD) developed by the Vitagen Company of LaJolla, Cal. According to her surgeon Michael Millis, MD, director of liver transplantation at University of Chicago Hospitals, the device slowed Orlyk's liver deterioration during the 36 hours it took to find a suitable organ for transplant. And it continued to filter her blood of toxins throughout the 5-hour operation, until her new liver began to function.

"Sheryl is doing extremely well, and her prognosis is excellent." Millis told Transplant News on May 11th, a week after Orlyk's surgery. "She's been moved out of the intensive care unit, is eating regular food, and should be discharged within a week."

The ELAD consists of 4 filtration cartridges, each seeded with 100 grams of genetically engineered liver cells. Plasma is removed from the patient's blood and pumped through the cartridges, where the liver cells detoxify it. The filtered plasma is then remixed with the other blood components and returned to the patient. Unlike extracorporeal devices using pig liver cells, which have a lifespan of only about 6 hours, Millis said the ELAD can provide continuous plasma filtration for extended periods of time--probably far longer than the 41 hours needed by Orlyk.

In addition to serving as a bridge to transplantation, it is hoped the ELAD might also prove a bridge to recovery. "Providing temporary, continuous support to acutely failing livers may allow them time to recover and begin functioning again, obviating the need for transplant," said Millis. "This is a possibility in fulminant failure because, unlike chronic failure, there is no liver scarring, so liver cells can regenerate."

Fulminant liver failure frequently is caused by medications, ingestion of poisonous mushrooms, and hepatitis A and B. But in about 50% of cases, Orlyk's included, the cause of failure is unknown. Millis said that these cases most likely are due to infection with some as yet unidentified virus.

Currently, the University of Chicago is the only center in the world testing the ELAD device.
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Publication:Transplant News
Geographic Code:1U3IL
Date:May 31, 1999
Words:373
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