Bridging the gap: advances in artificial liver support.

KEY POINTS: 1. The goals of liver support therapy include the following: To provide detoxification and synthetic function during liver failure. To remove or reduce the production of proinflammatory cytokines to correct the systemic inflammatory response of liver failure. To stimulate the regeneration of the injured liver and increase the likelihood of spontaneous recovery. 2. There is a large unmet need for a liver support device because of the shortage of organs for liver transplantation and the risks of major surgery. 3. Liver support devices can be divided into 2 groups: purely mechanical artificial devices and cell-based bioartificial devices. Both provide detoxification, but bioartificial liver devices provide the option of synthetic function and biotransformation activities that are not possible with a purely mechanical device. 4. An abundant high-quality supply of human hepatocytes is not currently available for liver cell therapy. However, such a supply is essential for successful bioartificial liver therapy. Novel options are under development for the unlimited production of high-quality human hepatocytes.