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Acute liver failure: liver support therapies

Stadbauer, V; Jalan, R; (2007) Acute liver failure: liver support therapies. CURR OPIN CRIT CARE , 13 (2) 215 - 221.

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Abstract

Purpose of reviewWe summarize the therapeutic approach to patients with acute liver failure with the main focus on bioartificial and artificial liver support. We also describe specific and general therapeutic approaches based upon recent advances in the understanding of the pathophysiology of acute liver failure.Recent findingsBioartificial liver support systems use hepatocytes in an extracorporeal device connected to the patient's circulation. Artificial liver support is intended to remove protein-bound toxins and water-soluble toxins without providing synthetic function. Both systems improve clinical and biochemical parameters and can be applied safely to patients. Although bioartificial liver-assist devices have not been shown to improve the survival of patients with acute liver failure, further development is underway. Artificial liver support systems have been shown to alter several pathophysiological mechanisms involved in the development of acute liver failure but survival data are still limited.SummaryMortality in patients with acute liver failure is still unacceptably high, The most effective treatment, liver transplantation, is a limited resource and so other therapeutic options to bridge patients to recovery or stabilization have to be considered. Better understanding of the pathophysiology of acute liver failure and device development is necessary to achieve the elusive goal of effective extracorporeal liver assist.

Type:Article
Title:Acute liver failure: liver support therapies
Keywords:acute liver failure, artificial liver support, bioartificial liver support, hypothermia, pathophysiology, FULMINANT HEPATIC-FAILURE, ADSORBENT RECIRCULATING SYSTEM, FRACTIONATED PLASMA SEPARATION, PROSPECTIVE CONTROLLED-TRIAL, I CLINICAL-TRIAL, BIOARTIFICIAL LIVER, ALBUMIN DIALYSIS, INTRACRANIAL-PRESSURE, PHASE-I, HEPATOCYTE TRANSPLANTATION

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