Review article: liver support systems in acute hepatic failure

The treatment of acute hepatic failure has developed rapidly over the last 40 years, reducing morbidity and mortality from this syndrome. Whilst this has been partly attributed to significant improvements in the specialist me dical management of these patients, advances in surgical techniques and pha rmaceutical developments have led to the establishment of successful liver transplantation programmes, which have improved mortality significantly. This review will examine the clinical impact of alternative methods that ha ve been used to provide extra-corporeal hepatic support. Non-biological bio logical and hybrid hepatic extra-corporeal support will be explored, offeri ng a comprehensive historical overview and an appraisal of present and futu re advances.