[Artificial liver support 1985].

Many techniques have been developed to support liver function in patients with hepatic failure. Only two of these methods are suited to be used in adequately equipped hospitals under appropriate safety conditions. Exchange of toxin-rich patient plasma against fresh frozen plasma will decrease plasma toxin levels and substitute coagulation factors and proteins. This procedure however should be used in intervals of at least 3-4 days because more frequent application will lead to lung or cerebral complications. Dialysis and hemofiltration will remove water soluble toxins from patient blood as well as excess amino acids which are considered to be precursors of toxic lipophilic metabolites. Addition of certain amino acids to dialysis fluid in physiological concentrations will help to avoid loss of essential amino acids (with approx. normal plasma concentration). In a very few special centers treatment by liver perfusion of human or pavian livers, or by liver transplantation can be performed.