Acute liver failure is a condition which requires liver transplantation: as the organ fails to function, it must be replaced soon; otherwise the rest of the body suffers immensely and eventually dies. Donor liver transplants are not available in abundance, so other ways of treatment are needed. New evidence suggests experimental cancer drug could replace transplantation.
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What is ALF?
Acute liver failure is a relatively rare condition, in which the liver fails to function due to being damaged severely. ALF occurs when more than 80% of liver cells become non-functional. If treatment is not provided within a very short period of time after symptoms develop, serious complications follow. If left untreated, the condition results in patient’s death.
As it calls for emergency surgery, there is not much time to find a donor liver transplant. In many cases, cadaveric transplants are used – these are the transplants taken from people who have recently died.
However, there are not enough transplants to supply everyone who needs a new liver, and that is why a new practice of living-donor liver transplantation emerged. The liver can regenerate really fast: its surprising ability to regrow itself within several months is something which researchers have long wished to embrace, and now such operations are becoming more popular. Around 30% of the donor’s liver is removed – their own liver will regain its previous volume within a couple of months, and adverse effects are rare (though there is still a 1% chance of death, so it is quite a risky business). The removed part is transplanted to the recipient – for them, liver regeneration will take some more time, but there is still chance the person will survive. While not all liver transplantations result in many years of happy life after the diagnosis, as of this moment, it is the only option available.
Even after living-donor liver transplantations had been introduced, the need for donor livers still remained. That is why scientists are constantly working on new approaches to treatment of this deadly condition. A recent research suggests it is possible to treat acute liver failure with the help of an experimental cancer drug.
A new approach
A team of scientists from the University of Edinburgh has recently reported that their issue-related experiments on mice had been a success. The researchers gave the rodents a drug which caused an overdose-induced liver failure. If untreated, it leads to death. Then the team administered a novel cancer drug, and the mice survived.
They also hypothesized that acute liver failure occurs due to the damage inflicted on liver cells as a result of senescence, which is part of ageing. The term describes the inability to function properly due to deterioration, but senescence in the liver is quite mystical: it spreads like a contagious disease, so many cells are affected. It remains unknown what triggers the process and whether it affects the tissues around the liver, i.e. whether it can expand to such an extent that it can damage other organs.
However complicated it may be, the researchers have already identified the signal involved in the process, and it is this signal that the experimental drug blocks.
If the new approach’s efficacy is proved in the course of further trials, it may some day be introduced in clinical practice to treat those patients who are experiencing acute liver failure and do not have a donor to share a piece of liver with them.
Liver Regeneration – science.sciencemag.org
Living Donor Liver Transplantation FAQs – columbiasurgery.org