title: Artificial liver support at present and in the future.
abstract: Liver failure is a fatal disease. Liver transplantation is the only established treatment for liver failure; however, donor shortages remain problematic. In the United States and Europe, artificial livers as a bridge to liver transplantation are being considered. In Japan, we have taken a different approach to the treatment of end-stage liver diseases because of the characteristics of the health-care insurance system, regulated by the government. Furthermore, cadaveric liver transplantations are unsuited to the social mores of Japanese culture. Practically speaking, we believe that plasma exchange (PE) and continuous hemodiafiltration (CHDF) are the most effective therapies for the treatment of liver failure, although randomized controlled studies are needed to determine their effects. Overall, we believe that the first line of treatment for liver failure should be PE and CHDF, and the second line should be bioartificial liver support. In the near future, we hope that both gene therapy and regenerative medicine will contribute to the development of a functional artificial liver.
authors.affiliation: Department of Surgery, Sapporo Hokuyu Hospital, Research Institute for Artificial Organs, Transplantation and Gene Therapy, 6-6-5-1 Higashi Sapporo, Shiroishi-ku, Sapporo, 003-0006, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Onodera
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sakata
authors.forename: Motoki
authors.initials: M
authors.lastname: Yonekawa
authors.forename: Akio
authors.initials: A
authors.lastname: Kawamura
mesh_terms: D002986:Clinical Trials as Topic; D005544:Forecasting; D017583:Hemodiafiltration; D022781:Hepatocytes / Q000637:transplantation; D006801:Humans; D007564:Japan; D017093:Liver Failure / Q000628:therapy*; D016031:Liver Transplantation; D019164:Liver, Artificial; D010951:Plasma Exchange