Extracorporeal perfusion for the treatment of acute liver failure.
OBJECTIVE
Because of the shortage of available donor organs, death rates from liver failure remain high. Therefore, several temporary liver-assisting therapies have been developed. This article reviews various approaches to temporary liver support as well as immunologic and metabolic developments toward a solution for this problem.


METHODS
A literature review was performed using Medline and additional library searches to obtain further references. Only articles with a well-defined aim of study and methodology and a clear description of the outcome of the experiments were included.


CONCLUSIONS
Renewed interest has developed in old and new methods for an extracorporeal approach to the treatment of acute liver failure. Although temporary clinical improvement has been established, further research is needed to achieve a successful long-term clinical outcome. New developments in the field of genetic modification and tissue engineering await clinical application in the near future.
Stockmann
H B
HB
Department of Surgery, University Hospital Dijkzigt and Erasmus University, Rotterdam, The Netherlands.
Hiemstra
C A
CA
Marquet
R L
RL
IJzermans
J N
JN
D000818:Animals; D006464:Hemoperfusion; D006801:Humans; D017114:Liver Failure, Acute / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D019164:Liver, Artificial; D010477:Perfusion; D013552:Swine; D014183:Transplantation, Heterologous / Q000276:immunology; D016896:Treatment Outcome