AIM:To investigate whether the function of hepatocytes co-cultured with bone marrow mesenchymal stem cells (MSCs) could be maintained in serum from acute-onchronic liver failure (ACLF) patients.METHODS:Hepatocyte supportive functions and cytotoxicity of sera from 18 patients with viral hepatitis B-induced ACLF and 18 healthy volunteers were evaluated for porcine hepatocytes co-cultured with MSCs and hepatocyte mono-layered culture,respectively.Chemokine profile was also examined for the normal serum and liver failure serum.RESULTS:Hepatocyte growth factor (HGF) and Tumor necrosis factor;tumor necrosis factor (TNF)-α were remarkably elevated in response to ACLF while epidermal growth factor (EGF) and VEGF levels were significantly decreased.Liver failure serum samples induced a higher detachment rate,lower viability and decreased liver support functions in the homo-hepatocyte culture.Hepatocytes co-cultured with MSCs could tolerate the cytotoxicity of the serum from ACLF patients and had similar liver support functions compared with the hepatocytes cultured with healthy human serum in vitro.In addition,cocultured hepatocytes maintained a proliferative capability despite of the insult from liver failure serum.CONCLUSION:ACLF serum does not impair the cell morphology,viability,proliferation and overall metabolic capacities of hepatocyte co-cultured with MSCs in vitro. AIM: To investigate whether the function of hepatocytes co-cultured with bone marrow mesenchymal stem cells (MSCs) could be maintained in serum from acute-onchronic liver failure (ACLF) patients. METHHODS: Hepatocyte supportive functions and cytotoxicity of sera from 18 patients with viral hepatitis B-induced ACLF and 18 healthy volunteers were evaluated for porcine hepatocytes co-cultured with MSCs and hepatocyte mono-layered cultures, respectively. Chemokine profile was also examined for the normal serum and liver failure serum .RESULTS: Hepatocyte growth factor (HGF ) and Tumor necrosis factor (TNF) -α were remarkably elevated in response to ACLF while epidermal growth factor (EGF) and VEGF levels were significantly decreased. Liver failure serum samples induced a higher detachment rate, lower viability and decreased liver support functions in the homo-hepatocyte culture. Hepatocytes co-cultured with MSCs could tolerate the cytotoxicity of the serum from ACLF patients and h ad similar liver support functions compared with the hepatocytes cultured with healthy human serum in vitro.In addition, cocultured hepatocytes maintained a proliferative capability despite of the insult from liver failure serum. CONCLUSION: ACLF serum does not impair the cell morphology, viability, proliferation and overall metabolic capacities of hepatocyte co-cultured with MSCs in vitro.