Acute Liver Failure and Bioartificial Liver Support

Acute liver failure (ALF) is a severe disease that can occur in healthy individuals. The current definition of ALF is acute liver injury associated with coagulopathy and altered mental status for less than 26 weeks with no prior history of liver disease. Even with liver transplant and modern intensive care, mortality is still as high as 30%. There are many causes for ALF, with acetaminophen overdose being the most common. Currently, liver transplantation is the most definitive treatment for ALF. However, with numerous disadvantages of liver transplantation, such as organ shortage and requirement of life-long immunosuppression, alternative therapies have been sought after by researchers. Liver support systems are one of the most studied alternative therapies, and many of them have reached clinical trial stage. Liver support systems can be further categorized into artificial and bioartificial support systems; bioartificial systems incorporate active hepatocytes to provide further liver function support. Currently, many liver support systems have been studied but none of them showed unequivocal survival benefit, and none of them are FDA-approved. One of the main aims of future studies is to develop a reliable method to mass produce hepatocytes for therapy and research purposes.