[Hybrid (bioartificial) systems for liver support. History and current developments].

Abstract

Attempts to develop liver support systems for the treatment of acute liver failure patients have ranged in the past, from the use of hemodialysis, or plasma exchange, or activated charcoal particles and synthetic resins, as well as the use of bioreactors loaded with liver tissue. However, no system demonstrated a significant improvement of patient survival, nor has achieved a wide clinical use. Liver transplantation remains the only treatment for severe hepatic failure that can improve patient survival. On the other hands, the chronic scarcity of organs for transplantation, leads to an urgent necessity of liver support systems. In this paper, we reviewed the historical experience and current status of artificial liver support systems, with particular emphasis on the so-called hybrid or bioartificial liver, in which to the traditional artificial components, such as selective membranes, charcoal particles and resins, isolated hepatocytes are used.