A breakthrough trial of an artificial liver without systemic heparinization in hyperbilirubinemia beagle models

The development of wearable artificial livers was restricted to device miniaturization and bleeding risk with water-soluble anticoagulants.Herein,a double-deck column filled with solid anticoagulant microspheres and Kevlar porous microspheres(KPMs,bilirubin adsorbents)was connected with the principle machine of wearable artificial liver(approximately 9 kg)to treat hyperbilirubinemia beagles for the first time.With the initial normal dose of heparin,the double-deck column could afford 3 h hemoperfusion in whole blood without thrombus formation.The removal efficiency of the double-deck column for total bilirubin(TBIL)was 31.4%.Interestingly,the excessive amounts of hepatocyte metabolites were also decreased by approximately 25%.The“anticoagulant+column”realized safe and effective whole blood hemoperfusion without the plasma separation system and heparin pump;however,the proposed principle machine of wearable artificial liver and“anticoagulant+column”cannot completely replace the bio-liver now.The intelligence of the device and the versatility of the adsorbent need to be improved;moreover,advanced experimental techniques need to be developed to validate the survival rates in animals.Overall,this study is a meaningful trial for the development of wearable artificial livers in the future.