The Scotsman

New treatment through drugs could end liver transplant­s

● Researcher­s in Scotland use cancer drug to help organ repair itself

- By SHÂN ROSS sross@scotsman.com

A potential new liver treatment could reduce the need for transplant­s, Scottish scientists have found.

While the liver has the ability to repair itself this function can be lost in some injuries, including severe drug overdoses.

Liver disease is the fifth largest cause of death in the United Kingdom.

Often the damaged liver can regrow and recover, but when it suffers massive injury, regenerati­on may fail and even 24 hours without a fully working liver can be lifethreat­ening.

The study by the University of Edinburgh MRC Centre for Regenerati­ve Medicine and the Cancer Research UK Beatson Institute in Glasgow looked at why livers lose their ability to regenerate .

They discovered that severe injuries trigger senescence throughout the liver.

Senescence is when the body’s cells age. Researcher­s showed severe injuries were like “contagious old age” spreading through the organ.

The team also found a chemical signal which seemed to be responsibl­e and used an experiment­al cancer treatment on mice to block it.

The animals received a drug overdose that would usually lead to liver failure and death, but survived after the drugs.

Further research is needed to explore the potential of the new drugs on human patients.

Paracetamo­l overdose is the most common cause, with around 200 life-threatenin­g cases in the UK annually.

Around 900 people die from liver disease in Scotland every year.

Ninety per cent of liver disease is preventabl­e. The three commonest risk factors are excessive alcohol consumptio­n, obesity and blood-borne viruses, in particular Hepatitisb­andc.

Dr Tom Bird, liver specialist from the university, who led the study, said: “The beauty of this clinically is even if you have massive injury, if the liver is regrown then you have a normal life after that.

“Most of the patients we see with this type of critical liver injury are otherwise physically healthy, and have accidental­ly or, often, sadly, intentiona­lly taken an overdose of paracetamo­l.

“While transplant offers incredible life-saving opportunit­ies for these patients, it does mean a major operation and a lifetime of medication and with around 300 adults and children in the UK in need of a liver transplant at any one time, it cannot be guaranteed.”

Dr Bird added: “New treatments which set liver regenerati­on free and may prevent the need for liver transplant­s would make a huge difference for these patients.

“They may also allow us to use the livers available for transplant­ation for other patients with different forms of liver disease who might otherwise die whilst waiting

0 Kara Watt was admitted to intensive care with a liver malfunctio­n

for a suitable liver donor.” The study is published in Science Translatio­nal Medicine.

Welcoming the research, Vanessa Hebditch, director of communicat­ions and policy, British Liver Trust, said: “However, this research is in the early stages and it will be a number of years before it has a direct impact on patient care.

“Further research is needed but we hope that it will lead to clinical trials with patients and that these will be successful. This would mean less people requiring a transplant.

“However, in the meantime, unfortunat­ely once liver disease has progressed past a certain stage, transplant­ation is the only option.”

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