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Artificial Liver Treatment: When and Which One?

  • Reference work entry
  • First Online:
Contemporary Liver Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

  • 1471 Accesses

Abstract

Patients awaiting liver transplantation often are in critical condition with multi-organ failure accompanying the underlying liver disease. Stabilization and safe bridging of the patient to transplantation is a major indication for liver support methods. Various extracorporeal technologies have been tested clinically since the late 1950s. Currently, methods are divided into artificial, or nonbiological, systems based mainly on filtration and adsorption techniques and biological methods employing liver cells, typically of human, sometimes of animal origin. Examples of currently used liver support methods are the molecular adsorbent recirculating system (MARS) as an artificial system and the extracorporeal liver assist device (ELAD) as a biological liver-cell bioreactor. However, a considerable number of other approaches have been studied before or are currently under investigation. As of today, the best clinical experience exists for the MARS system.

Liver support treatment should be considered early in the course of liver failure. Stabilization of various organ functions including circulatory, hepatic, and renal function, improvement of hepatic encephalopathy, and reduction of elevated intracranial pressure were observed in clinical studies. Modern extracorporeal liver support methods are safe to perform and a valuable addition to the therapeutic armamentarium of liver failure care.

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This chapter uses parts of the previously published article Mitzner S: Extracorporeal liver support- albumin dialysis with MARS. Annals of Hepatology 2011; 10 Suppl 1:S21–8 (Mitzner 2011) with written permission by the publisher.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, University of Rostock, Rostock, Germany

    Steffen Mitzner

  2. Fraunhofer IZI Project Group “Extracorporeal Immunomodulation”, Rostock, Germany

    Steffen Mitzner

  3. Institute for Biomedical Engineering, University of Rostock, Rostock, Germany

    Niels Grabow

  4. Charité Research Organisation, Virchow-Klinikum, Berlin, Germany

    Sebastian Klammt

Authors
  1. Steffen Mitzner
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  2. Niels Grabow
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  3. Sebastian Klammt
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Correspondence to Steffen Mitzner .

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Editors and Affiliations

  1. Nicoletti Family Professor of Transplant Surgery, Director, Jefferson Transplant Institute, Director, Division of Transplantation, Surgical Director, Kimmel Cancer Center – Jefferson Liver Tumor Center, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA

    Cataldo Doria

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Mitzner, S., Grabow, N., Klammt, S. (2017). Artificial Liver Treatment: When and Which One?. In: Doria, C. (eds) Contemporary Liver Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07209-8_29

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  • DOI: https://doi.org/10.1007/978-3-319-07209-8_29

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