Temporary Replacement of Phagocytic Function of the Liver - Importance for the defence of Infections during hepatic failure

The phagocytic system is one of the main immune barriers in the defence system against living or dead external partikels and substances. Especially von Kupffer Stern-Cells of the liver play a major role in filtering the blood that is coming from the gut and that often is loaded with endotoxins and even living bacteria. In liver failure, not only hepatocytes but also non-parenchymal cells have lost their function. Furthermore, because of the impaired blood circulation in the gut, more foreign substances than usual are able to enter the gut mucosa and subsequently the systemic blood system. This very often results in septic complications in patients with hepatic failure, even during the recovering of the hepatic function due to conventional or extracorporeal treatment.

So far, the improvement of the impaired phagocytic function of the non-parenchymal liver cells has not been a choice in the clinical treatment.

After having shown the function of biotech-expanded human phagocytes in-vitro, we now describe in-vivo results of an extracorporeal blood treatment of sepsis. Human hematopoetic precurser cells have been expanded and differentiated toward functional granulocytic cells. These cells have been involved in the extracorporeal treatment of two different bacterial sepsis models. Both in the treatment of rats with a gramnegative E.coli sepsis as well as of pigs with a grampositive Staph. aureus sepsis treated animal had a significant benefit. In the pig model, the animals have been treeted by a single 6 hhour treatment of the separated plasma with about 10⁹ human phagocytic cells and than be observed for one week. Starting point for the treatment was about one hour after the end of the infusion of the Staph. aureus solution. Both outcome and clinical parameters significantly improved in the treatment group.

Major attempts will now be made concerning the transfer of this new treatment option into the clinic. Combination with extracorporeal hepatic treatments might reduce septic complications of hepatic failure.

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