Membrane bioreactors for regenerative medicine: an example of the bioartificial liver

Liver transplantation is the only established treatment for liver failure. Because of the organ scarsity, liver support strategies are being developed with the aim of either supporting patients with the borderline functional liver cell mass until the organ transplantation or liver regeneration. A bioartificial liver (BAL) consisting of functional liver cells supported by an artificial cell culture material could provide a vital temporary support to patients with liver failure, and could serve as a bridge to transplantation while awaiting a suitable donor. In this paper, we discuss the critical issues for the development of BAL such as bioreactor configuration, mass transfer, cell source and culture technique. The characteristics of membrane BAL systems in clinical, preclinical and in vitro tests are reviewed. Membrane bioreactors used for the generation of in vitro physiological model systems for studying biological mechanisms and testing the efficacy of potential therapies are also discussed. (C) 2009 Curtin University of Technology and John Wiley & Sons, Ltd.