Barriers to the successful treatment of liver disease by hepatocyte transplantation

Treatment of patients with liver disease by hepatocyte transplantation has expanded dramatically over the last decade, especially for treatment of patients with liver-based metabolic disorders. While much progress has been made, full realization of its potential has not been reached. Treatment of acute liver failure has been hampered by a number of factors, but the efficacy of hepatocyte transplantation in treating this entity could be better determined through a multi-institutional trial using a uniform and standardized treatment strategy. The barriers to treating chronic liver failure resulting from cirrhosis are more extensive. Novel strategies are being developed to safely precondition patients with liver-directed radiation therapy in order to enhance donor hepatocyte survival, long-term engraftment and improve treatment of patients with life-threatening liver-based genetic deficiencies. This work could soon be translated to the clinic. Once hepatocyte transplantation has been shown to effectively replace organ transplantation for a portion of patients with liver failure and life-threatening liver metabolic diseases, it is likely that multiple novel sources of donor hepatocytes will be developed, making cell therapy available and effective for a broad population of patients with liver disorders.