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The establishment of a reliable large animal model of acute hepatic failure (AHF) is critical for the evaluation of supportive therapies such as bioartificial liver support systems (BALSS).
Suggestions are made for the most suitable large animal model to test liver support systems.
Liver tissue engineering initially focuses on developing liver support devices to bridge transplantation.
A more extreme form of biological liver support could be considered hepatocyte transplantation and auxiliary liver transplantation.
Advanced dialysis systems like liver support devices are capable of eliminating albumin bound substances (such as serum BAs) [57, 58].
These properties can be exploited for the design of innovative bioartificial liver support devices (BALSDs) using primary hepatocytes.
We suggest further developments in design and appropriate strategies of anticoagulation to improve the biocompatibility of artificial liver support.
To test safety, technical applicability and therapeutic effect of liver support systems, reliable animal models are needed.
Various liver diseases result in terminal hepatic failure, and liver transplantation, cell transplantation and artificial liver support systems are emerging as effective therapies for severe hepatic disease.
The significant array of liver support systems available would suggest that the design, clinical utilization and end points for success remain poorly defined.
There are several answers to this problem: improving the effectiveness of the organ harvesting network, developing new surgical methods and upgrading liver support devices.
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