The development of artificial livers

Risk factors of nosocomial infection in patients underwent artificial liver support system: a retrospective case-control study

BACKGROUND

Although nosocomial infection is one of the most discussed problems in patients undergoing artificial liver support system (ALSS) treatment, only few solutions have been proposed so far. This study aimed to explore the risk factors of nosocomial infection in patients treated with ALSS in order to aid in the development of future preventive measures.

METHODS

This retrospective case-control study included patients treated with ALSS at the Department of Infectious Diseases, First Affiliated Hospital of xxx Medical University between January 2016 and December 2021.

RESULTS

One hundred seventy-four patients were included. There were 57 patients in the nosocomial infection group and 117 patients in the non-nosocomial infection group, of them 127 males (72.99%) and 47 females (27.01%) with an average age of 48.15 ± 14.19 years old. Multivariate logistic regression analysis revealed that total bilirubin [odds ratio (OR) = 1.004; 95% confidence interval (CI), 1.001-1.007; P  = 0.020], number of invasive procedures (OR = 2.161; 95% CI, 1.500-3.313; P  < 0.001), blood transfusion (OR = 2.526; 95% CI, 1.312-4.864; P  = 0.006) were independent risk factors and haemoglobin (Hb) (OR = 0.973; 95% CI, 0.953-0.994; P  = 0.011) was a protective factor for nosocomial infection in patients treated with ALSS.

CONCLUSION

The total bilirubin, transfusion of blood products and higher number of invasive operations were independent risk factors for nosocomial infection in patients treated with ALSS, while higher Hb was a protective factor.

Conformations and dynamic behaviors of confined wormlike chains in a pressure-driven flow

The conformations and dynamic behaviors of wormlike chains confined by a slit in a pressure-driven flow were investigated using dissipative particle dynamics method. The wormlike chains exhibit varying conformations due to the varying shear stresses across the slit. The wormlike chain solution can be well described by the power-law fluid, and the power-law index decreases with the increase in chain rigidity. We also presented that the wormlike chain undergoes tumbling motion in the vicinity of the wall in the presence of pressure-driven flow. We also found that the wormlike chains can migrate both away from the wall and slightly away from the slit center, and the migration away from the slit center increases as the chain rigidity is increased because of hydrodynamic interactions induced in a more rigid wormlike chain.

Bioartificial livers: a review of their design and manufacture

Acute liver failure (ALF) is a rapidly progressive disease with high morbidity and mortality rates. Liver transplantation and artificial liver support systems, such as artificial livers (ALs) and bioartificial livers (BALs), are the two major therapies for ALF. Compared to ALs, BALs are composed of functional hepatocytes that provide essential liver functions, including detoxification, metabolite synthesis, and biotransformation. Furthermore, BALs can potentially provide effective support as a form of bridging therapy to liver transplantation or spontaneous recovery for patients with ALF. In this review, we systematically discussed the currently available state-of-the-art designs and manufacturing processes for BAL support systems. Specifically, we classified the cell sources and bioreactors that are applied in BALs, highlighted the advanced technologies of hepatocyte culturing and bioreactor fabrication, and discussed the current challenges and future trends in developing next generation BALs for large scale clinical applications.