[Liver replacement therapy. Reliable indications in acute liver failure]

Area of Science:

• Hepatology
• Biomedical Engineering

Background:

• Liver failure presents a high mortality rate, necessitating advanced therapeutic options.
• Extracorporeal liver support devices are being developed to aid liver function restoration or bridge to transplantation.
• Current treatments face challenges in managing the dynamic nature of liver disease.

Purpose of the Study:

• To provide an overview of various extracorporeal liver support methods and devices.
• To evaluate the clinical evidence supporting these devices.
• To offer recommendations for the management of these specialized and costly devices.

Main Methods:

• Review of artificial and bioartificial liver support systems.
• Analysis of different extracorporeal liver perfusion techniques.
• Assessment of clinical evidence for dialysis, hemoadsorption, and hepatocyte-based procedures.

Main Results:

• Various artificial (dialysis, hemoadsorption) and bioartificial (hepatocyte-based) devices are under investigation.
• Different extracorporeal liver perfusion methods are being tested.
• Clinical evidence for widespread application outside of studies is currently lacking.

Conclusions:

• Extracorporeal liver support devices aim to enhance treatment for liver failure.
• Current data does not support the use of these devices outside of clinical trials at specialized centers.
• Further research is needed to establish definitive indications and optimize the use of these advanced therapies.