[The present status and the future of artificial liver support]

Orthotopic liver transplantation, started by Dr. Starzl in 1963, has already become an well established therapeutic method for the treatment of fulminant hepatic failure especially since the introduction of Cyclosporin A. On the other hand, hemoadsorption using charcoal, PAN membrane hemodialysis and plasma exchange were actively applied for clinical cases with fulminant hepatic failure between 1960 and 1970, but the survival rates were not so improved as expected due to the lack of metabolic functions. Hybrid artificial liver has been therefore investigated experimentally to support metabolic functions by using biomaterials such as isolated hepatocytes. Today many efforts are being made to keep hepatocytes highly viable for a long period of time by calcium alginate entrapment, spheroid formation, or by using biomatrix, some polymers, and microcarriers, etc. In the future, xeno-hepatocytes or so-called super cell will be realized and applied for artificial liver support with the development of gene operation techniques.