Importance of the kinetic characterization of liver cell metabolic reactions to the design of hybrid liver support devices

Hybrid liver support devices (HLSDs) developed for the treatment of fulminant hepatic failure often perform well on a laboratory scale but rapidly lose their metabolic functions, or are not therapeutically effective, on a clinical scale. This suggests that the procedures adopted so far for the design of HLSDs are susceptible to improvement. In this paper, we discuss how essential a reliable and thorough kinetic characterization of the liver cell metabolic reactions is to the design of a clinically effective membrane HLSD. The features of the bioreactors used for the kinetic characterization of liver cell reactions are presented and discussed on the basis of the multifactorial nature of such reactions. The relevance of kinetics to the design of a membrane HLSD is also discussed with respect to the effect of the kinetics of oxygen consumption on the performance of the device.