AIM:To assess the efficacy and safety of TECA type hybridartificial liver support system(TECA-HALSS)in providingliver function of detoxification,metabolism and physiologyby treating the patients with acute liver failure(ALF).METHODS:The porcine liver cells(1-2)×1010wereseparated from the Chinese small swine and cultured in thebloreoctor of TECA-BALSS at 37.0℃ and circulated throughthe outer space of the hollow fiber tubes in BALSS.The sixliver failure patients with vadous degree of hepatic comawere treated by TECA-HALSS and with conventionalmedicines.The venous plasma of the patients wasseparated by a plasma separator and treated by charcoaladsorbent or plasma exchange.The plasma circulatedthrough the inner space of the hollow fiber tubes of BALSSand mixed with the patients’ blood cells and flew back totheir blood circulation.Some small molecular weightsubstances were exchanged between the plasma andporcine liver cells.Each treatment lasted 6.0-7.0h.Physiological and biochemical parameters were measuredbefore,during and after the treatment.RESULTS:The average of porcine liver cells was(1.0-3.0)×1010obtained from each swine liver using our modifiedenzymatic digestion method.The survival rate of the cellswas 85%-93% by trypan blue stain and AO/PI fluorescentstain.After cultured in TECA-BALSS bioreactor for 6 h,thesurvival rate of cells still remained 70%-85%.At the end ofTECA-HALSS treatment,the levels of plasma NH3,ALT,TBand DB were significantly decreased.The patients who werein the state of drowsiness or coma before the treatmentimproved their appetite significantly and regainedconsciousness,some petients resumed light physical workon a short period after the trestment.One to two days afterthe treatment,the ratio of PTA increased warkedly.Duringthe treatment,the heart rates,blood pressure,respirationcondition and serum electrolytes(K~+,Na~+ and cr)werestable without thrombosis and bleeding in all the sixpatients.CONCLUSION:TECA-HALSS treatment could be a rapid,safe and efficacious method to provide temporary liversupport for patients with ALF.
