Experimental artificial liver support with emphasis on fulminant hepatic failure: concepts and review.

Coated charcoal hemoperfusion started in the earlier grades of coma appears to improve the survival rate of drug-induced FHF. This is based on randomized control animal studies and clinical trials using historical controls. Even if randomized clinical trials in patients should substantiate these findings, it is still a very small step in artificial liver support. Viral-induced FHF and cirrhotic encephalopathy are much more common conditions that still cannot be supported. However, this initial promising step should encourage us to become more optimistic about the possibility of developing artificial livers for the higher levels of support. A multifaceted approach in research should include evaluations of combined approaches. Increased basic knowledge in toxic and essential substances will be another important requirement.