SHORTAGE OF LIVER DONORS? WHAT IS THE ALTERNATIVE?
by Sanele Mdletshe
The liver is the most important organ of the body, it performs crucial metabolic functions, and these includes metabolizing toxic substances, producing bile for digestion and maintaining blood sugar levels. It is a very unique organ that is able to repair itself after damage, but this is not the case if the injury has progressed to cirrhosis, which is a chronic liver damage as a results of alcohol abuse or hepatitis. The ultimate treatment for end-stage cirrhosis is liver transplantation, but the shortage of donors remains a major obstacle. According to the global observatory on donation and transplantation, in 2020, the liver was the second most transplanted organ to save people’s lives. GLOBACAN estimates indicate that chronic liver diseases and liver cirrhosis contribute to more than 1 million deaths annually across the world.
In this study, researchers looked at the alternative options for treatment of chronic liver diseases and liver failure. The study was conducted based on the application of the principles of regenerative medicine and tissue engineering. Briefly, the aim was to use induced pluripotent stem cells (iPSCs) to enhance the repair of the liver after cirrhosis, this is due to their pluripotent properties which allows them to differentiate into all cell types including liver cells. iPSCs were generated by transfecting somatic fibroblasts with four transcription factors (OCT4, SOX2, KLF4 and MYC) famously known as “Yamanaka factors”.
In this study, authors established a three-step protocol to generate iPSC-derived hepatocytes that can be an alternative treatment for chronic liver diseases and liver failure, as assessed in mice with lethal fulminant hepatic failure. This protocol is very rapid and efficient as it takes only 12 days.
The use of iPSCs holds a great promise in medicine, its advantages includes overcoming ethics against the use of human embryonic stem cells, reduces the risk of immunosuppression as these cells are generated from the patient’s somatic cells.
Chen, Y., Tseng, C., Wang, H., Kuo,H., Yang, V.W., and Lee O.K. 2012. Rapid generation of mature hepatocyte-like cellsfrom human induced pluripotent stem cells by an efficient threestep protocol.