[Liver substitution and liver grafting (author's transl)]

The possibilities of an artificial liver substitution are very limited; at most various partial functions of the liver can be substituted for a short time. Technically, the various modifications of hemoperfusion are given first importance, especially hemoperfusion through a carbon filter. But the best possible intensive therapy with substitution of the substances reduced by insufficiency of the liver, e.g. coagulation factors, is the most important measure in the treatment of hepatic coma at the present time. Shortterm biological substitution with extracorporeal perfusion of a primate liver is possibly the most suitable form of liver substitution. Longterm substitution can only be possible and thought of by liver grafting. In recent years some workers have obtained marked improvement, especially reduction of mortality, with clinical orthotopic liver grafts.