The 'bio-artificial' liver machine, an American invention, has been used on five acute liver-failure patients in London, of whom four at King's College Hospital have survived. The man who died was more seriously ill.
The artificial liver contains cartridges of human liver cells and provides a lifeline for patients giving them time for their own livers to recover.
The liver unit at King's has been chosen for the first full trial because of the range of its expertise. 'We hope that the machine will be able to sustain patients' lives while their own livers recover,' Dr Roger Williams, director of the unit, said. 'We are still at the stage of fact-finding and testing for safety. It is hard to say just how much work the machine is doing as we are trying to use it on patients who are not so ill, who do have some liver function left . . . We are hopeful.'
The British patients have used the machine for periods of 48 hours at a time. A dozen will be put on the bio-artificial liver before a full trial begins.
The machine, called the Hepatix artificial liver, works in a similar way to a kidney machine. But the human liver, the body's 'chemical factory', is a much more complex organ and it has not been possible to devise wholly artificial means of replicating its function. So, unlike a kidney machine, the liver machine uses bio-technology. The patient's blood is passed through cylinders containing cloned human liver cells that give 20 to 30 per cent of the liver's natural function.
The cloned cells are 'seeded' into 10,000 special fibres which are contained in cartridges where they continue to multiply until each cartridge contains about 200 billion cells. This is equivalent to around 20 per cent of an adult liver. The patient's blood is passed through the fibres coming into contact with the liver cells which behave in the same way as a liver. The blood is returned to the body.
Dr James Kelly, a biochemist from Houston, Texas, and the co-inventor, said: 'One of the best things about the cartridges is that we feed the cells with a special nutrient and we have kept the devices 'alive' for months and months.' Patients with less than 20 per cent of their own liver function were likely to die inside a week. 'The artificial liver provides a survival bridge,' he said.
In Britain, there are about 550 liver transplants a year, each costing pounds 20,000 to pounds 30,000. About 120 people are waiting for liver transplants and, each year, some 50 people on the list die before a new liver becomes available. Treatment per person with the liver machine costs about pounds 13,600.
Scientists in Los Angeles have developed a potential cure for diabetes which involves transplanting insulin- producing cells taken from a dead donor in to the abdomen of a patient, writes Liz Hunt.
A 38-year-old man who was the first to receive the treatment now no longer needs daily insulin injections, and has returned to work for the first time in a decade after undergoing the transplant.
The cells, taken from the pancreas of the donor, were encapsulated in a membrane specially designed to protect them from attack by the body's immune system. This overcame the problem of rejection which has dogged previous attempts at transplants.