Hepatocyte transplantation-biology and application.

Transplantation of liver has been remarkably effective in the treatment of liver failure and liver-based inherited metabolic diseases and has revolutionized the care of patients with end-stage liver disease. Unfortunately demand for transplantable livers is progressively outpacing the supply of donated cadaver organs, resulting in longer waiting times and increased mortality for prospective transplant recipients. Hepatocyte transplantation has been proposed as a method to support patients with liver insufficiency. The current knowledge on this method has been review in this article. Now the two-step collagenase perfusion technique is widely used for isolation of hepatocytes. Liver has been considered as an optimal site for hepatocyte transplantation, however, even in this organ the survival rate of transplanted hepatocytes in extremely low. The main obstacle for wider usage of hepatocyte transplantation is their rapid elimination by recipient macrophages. We tried in animal experiments to downregulate the innate process of recipient cellular attack on implanted hepatocytes by irradiation of recipient and elimination of NK cells. Ligation of bile duct and partial hepatectomies facilitated proliferation of accepted donor hepatocytes and formation of bile canaliculi. The described method is now adjusted to clinical conditions.