Artificial support systems for liver failure

The poor prognosis of patients with acute liver failure has stimulated investigation of various approaches to extracorporeal support systems, as outlined above. However, the knowledge of basic organ physiology and the understanding of the pathophysiology of organ failure which were the basis for the development of successful dialytic therapy for renal insufficiency are not available for the liver. Hence, it is essential that further basic research be generously supported and pursued simultaneously with the further development of empirical devices. In view of the variable natural history of acute liver failure, it is also important that all new devices available to clinicians be evaluated from the outset with randomized controlled trials. To date, none of the approaches tested clinically have conclusively proved to be of benefit in the setting of fulminant hepatic failure.