Abstract
Over the last 40 years, the treatment of acute hepatic failure (AHF) has developed rapidly, leading to a reduction in morbidity and mortality. Part of this reduction is attributable to marked improvements in the specialist medical management of these patients, but advances in surgical techniques and pharmaceutical treatments have resulted in successful liver transplant programs being established, significantly improving mortality. However, the success of transplantation programs isdependent upon organ availability and retrieval, and many patients are either unsuitable for transplantation or die before a suitable donor is found. In order to further reduce morbidity and mortality, alternatives techniques to support the failing liver have been explored. This review examines the clinical impact of the techniques that have been used to provide extracorporeal hepatic support. Non-biological, biological and hybrid support are discussed, offering a comprehensive historical overview and an appraisal of current and future technologies.