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.