Clinical experience with an extracorporeal liver assist device

Acute liver failure (ALF) results in failure of the body to sustain vital metabolic functions such as energy production, protein synthesis, and detoxification–excretion of metabolic by products. In addition, experimental evidence suggests that plasma from patients with ALF is cytotoxic (Seda et al. 1984a), possibly as the result of cytokine and free radical release from the necrotic liver (Nagaki et al. 1991). This combination of decreased metabolic reserve and increased levels of cytotoxic compounds determines the severity of the clinical syndrome which follows.