Liver support systems: a 1978 perspective

The present status of support systems and devices for the injured liver is reviewed with emphasis on both long-term and short-term substitution. Long-term replacement can only be possible by the grafting or transplantation of a human and/or other primate liver. Most artificial systems may be applied for short-term biological and technical substitution, e.g., by hemodialysis/hemoperfusion through adsorbents and resins. More sophisticated devices for detoxification of blood or cell-free plasma in acute liver failure should combine the catalytic specificity of immobilized microsomal enzymes with the adsorptive capacity of activated charcoal, resins and affinity gels.