Engineered liver-inspired collagen matrix as a high-performance hemoperfusion adsorbent for bilirubin removal

Abstract Highly efficient removal of bilirubin from blood by hemoperfusion for liver failure therapy remains a great challenge in the clinical field due to the unsatisfied biocompatibility of non-biological materials and the slow adsorption kinetics of currently used bilirubin adsorbents. Here, inspired by the natural collagen-supported multiscale structures of the liver for bilirubin removal, a natural collagen-based artificial liver, named ColAL, was successfully constructed via a biomimetic synthetic strategy. ColAL exhibited a record-high adsorption capacity of 102.32 mg g−1 for bilirubin in the presence of 40.0 g L−1 bovine serum albumin. The ColAL also presented excellent bilirubin adsorption capacity in the complex serum. Importantly, the total bilirubin (TBIL) removal rate was higher than 69.17% and the direct bilirubin (DBIL) removal rate was 75.31% by immersing the ColAL in ex vivo blood samples. No damages were observed in the major organs after the injection of ColAL extract solution subcutaneously in vivo, indicating high biocompatibility and biostability of these natural collagen-based materials. This facile approach provides a new avenue to develop collagen-based high-performance hemoperfusion adsorbent for the removal of bilirubin, showing great promise to the translational therapy of hyperbilirubinemia.