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Comment by coder1001 | Hacker News Reader

One great use of this could taking good parts of a cancer's patient's liver, regrowing the parts independently and then putting back the part that does not show any sign of cancer.

Not sure if one week will do it, but could be very viable when this tech is extended to more than a week.

Major advantage of reusing one's liver is the body would be less likely to reject it, hence relying less on immune suppression medications.

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You hit the nail on the head. The tech needs to be extended more than a week without massive necrosis (which occurred in 4/10 livers in the study). I think that's something the authors of the Nature paper needed to have measured more of continuously (on top of the ATP production, BUN clearance, etc). Not sure which markers, to be honest, but there should be a decent range of apoptotic factors that can be sampled.

I wonder if they could just break the liver up into pieces, junk the 4/10 pieces that went oogy, keep and merge the rest?

Apparently at least 25% of the liver is needed to regenerate into a whole liver. So at most you could break it up into 4 pieces (or maybe 3 to be on the safe side).

Unfortunately most liver cancer is metastases from elsewhere, and once its in the liver, its likely to have spread to other organs as well, so this will not affect prognosis as you say until the cancer itself is treated.

You mean "most cancer in the liver" and not liver cancer. Liver cancer means HCC, as in the cancer originated from there.

I do, but the issue is also true for HCC, as the damage is often quite diffuse and less amenable to resection (DOI- not a liver doctor)

Can a person survive without a liver for 1 week?

Based on the experiences of a friend & close family member & what the doctors said: when your liver stops functioning, you will have about six weeks to live. The prognosis schedule was pretty much spot-on in both cases,and the last week has much less useful consciousness. Since the first few weeks are not really debilitating, I'd wager that one week without a liver to re-implant a repaired organ should be a good plan.

Out of curiosity: Amanita poison I thought mostly attacked the liver and leads to death in much less than 6 weeks (more like a few days, maybe a week). So I assume the 6 weeks means massive effort in the ER to stabilize the patient without liver, maybe some advanced blood filtering?

Interesting discrepancy.

Both the ones I knew were in hospice and not a huge intervention for the six weeks, so not a tone of continuing intervention.

I'd guess that liver failure is maybe defined not as 100% failure, but failure to keep up with daily demand due to an external impairment such as cancer, and that this is just a typical curve of declining function until the body becomes too poisoned to survive.

Anybody with more detailed real bio/medical information?

My medical education is congruent with your thoughts. Liver failure is defined as partial or complete loss of function. You're also right about the "too poisoned to survive" aka end-stage liver disease. People in this stage often die from too much toxin build up, infection, or bleeding. Your explanation is great.

Thanks! very helpful.

There might be necrosis of the liver involved, which adds a dump of toxins on top of non-functioning liver.

You wouldn't necessarily have to remove all of the liver. If you take say 50% of it, then the other 50% can regrow assuming a good chunk of it is still alive.

No. My brother suffered acute liver failure following a diagnostic procedure to check his brain after having brain cancer surgery. He survived two weeks. And they were a horrible two weeks.

I'm sorry for your loss. I hope no one has to go through this again with the advances in this new liver extending technology.

I've always been amazed how livers can regenerate. But I recall reading the new liver is not a perfect copy there's some loss of function. I tried to find out what it was that I read but I can't find anything about it.

I think it regenerates the bulk tissue but cannot reform the major arteries, veins and ducts.

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