Body Location of the Liver If you place your right hand over the area under the ribs

on the right side of your body it will just about cover the area of your liver. The liver is the largest gland, and the largest solid organ in the body, weighing some 1.8 kgs in men and 1.3 kgs in women. It holds approximately 13% (about one pint or 0.57 litres) of your total blood supply at any given moment and is estimated to have over 500 functions.

What is the liver? The liver is dark reddish brown in colour and is divided into two main lobes (the much larger right and the smaller left) which are further subdivided into approximately 100,000 small lobes, or lobules. About 60% of the liver is made up of liver cells called hepatocytes which absorb nutrients and detoxify and remove harmful substances from the blood. A hepatocyte has an average lifespan of 150 days. There are approximately 202,000 in every milligram of your liver tissue. Two-thirds of the body of your liver is the parenchyma, which contains the hepatocytes, and the remainder is the biliary tract. It receives its blood supply via the hepatic artery and portal vein (which transports nutrients from your intestine, or gut). Biology of liver:

The major function of liver : The liver is the largest gland in the body and performs an astonishingly large number of tasks that impact all body systems.here we will foucs on main liver's function, but there are more than 500 functions : processing digested food from the intestine controlling levels of fats, amino acids and glucose in the blood combating infections in the body clearing the blood of particles and infections including bacteria neutralising and destroying drugs and toxins manufacturing bile storing iron, vitamins and other essential chemicals breaking down food and turning it into energy manufacturing, breaking down and regulating numerous hormones including sex hormones making enzymes and proteins which are responsible for most chemical reactions in the body, for example those involved in blood clotting and repair of damaged tissues.

What can go wrong with liver:

Your liver is a very uncomplaining organ. There is very little evidence that the liver has an ageing problem and without disease it can function fully right into old age. Most liver disease does not show symptoms and, when it does, the symptoms are often vague. There are hundreds of liver disorders but some are quite rare. The most common are:

Hepatitis

Viral hepatitis Hepatitis A Hepatitis B Hepatitis C Autoimmune Hepatitis Cirrhosis Alcoholic Liver Disease Gallstone and gallbladder disease Haemochromatosis Wilson's disease Cancer of liver.

Reality Check
In reality, the liver is an organ that has multiple function, many of which cannot be replicated by a machine. the most effective treatment of liver damage is a liver transplant.Therefore, the role of an artificial liver is to sustain life until a liver transplant is possible, or long enough for the liver to regenerate itself. One of the original problems for artificial liver is that a machine cannot create the enzymes and chemicals that a real liver can.The only current solution to failure is a liver transplant.

What does a Artificial Liver need to do?

Cellular components must be purified and every component in it mustbe clearly identified. The cellular preparation must be clearly shown to not transmit anyinfectious diseases of any kind. The cellular component must stay viable and active The synthetic component must be fully biocompatible, integrity of thematerial and parts must also be demonstrated The device must be able to introduce the therapeutic and regulatorymolecules that a healthy

liver provides, and it must also filter substancesfrom the blood the way that the normal liver does. Must be immunocompatible. Blood must perfuse properly through system

Liver Dialysis Unit

FDA approved in 1994 Plate dialyzer with blood on one side, dialysate is a mixture of sorbents, activated charcoal being the essential component.For a substance to be removed, must be dialyzable and able to bind to charcoal.Bridge to recovery for treat acute hepatic encephalopathy and overdoses of drugs Post-market trials have shown the LDU to be effective in improving physiological and neurological status.

MARS Limited to investigational use in US.Hollow fiber membrane hemodialyzer. Blood on one side, human albumin on other. Albumin recycled through circuit containing another dialyzer and carbon and anion exchanger adsorption columns. Removes both water-soluble and protein bound substances Keep valuable proteins,Trial have found it safe and associated with clinical improvement

ELAD Uses cultured human hepatocytes express normal liver-specific metabolic pathways. hollow fiber dialyzer. Dialyzer cartridge connected to continuous hemodialysis machines, like those used for renal therapy. Blood separated into a cellular component and a plasma component. Plasma through dialyzer, hepatocytes on outside of hollow fibers. Currently involved in a phase 2 clinical trial to evaluate the safety and efficiency.

BLSS Extracorporeal hemofiltration hollow fiber membrane bioreactor with 100 grams of primary porcine hepatocytes Whole blood is filtered Contains blood pump, heat exchanger, oxygenator to control oxygenation and pH, and hollow fiber bioreactor Currently undergoing phase I/II clinical trials Patients show some improvement

HepAssist 2000 System Four components: a hollow fiber bioreactor containing porcine hepatocytes, two charcoal filters, a membrane oxygenator, and a pump. Must be used in conjunction with a commercially available plasma separation machine Blood separated; plasma processed through charcoal filters to remove particulates, bacteria, then enters bioreactor Hepatocytes must be heated and oxygenated FDA mandated full Phase III trials

LIVERx2000 Hollow fiber cartridge Primary porcine hepatocytes suspended in a cold collagen solution and injected inside fibers Blood circulates outside the hollow fibers Designed to treat both acute and chronic liver failure Phase I/II clinical trials are underway to test the safety of efficacy of this device Anyone treated with the LIVERx2000 will be monitored for PERV

MELS

Parallel plate design Human hepatocytes attached to semipermeable membranes on parallel plate Plasma separator, then plasma passes into the bioreactor In the bioreactor, the plasma flows over the semipermeable membrane where the hepatocytes are adhered. Current trials in Europe show promise

Demographics and Cost

Market for liver support is estimated to be substantial: $700 million in the United States and $1.4 billion worldwide. Liver transplants have more than doubled in the past ten years, with the transplant waitlist growing in a similar fashion.

Current and Future Challenges

GOAL: To produce a fully implantable bioartificial liver.

Problems: Cell viability Fibrosis around implanted capsules Proteins greater than pore size cannot be released To achieve density of cells needed to replace liver, an estimated 1000m of hollow fibers would be needed