Fulminant liver failure (FHF) is associated with a high rate of mortality. Cell-based liver support systems have been developed for the treatment of FHF to prevent the development of potentially life-ending complications such as cerebral edema, intracranial hypertension, and brain herniation. Extracorporeal liver support systems, such as the bioartificial liver (BAL), contain hepatocytes intended to provide auxiliary hepatic function as a bridge to liver transplantation. Clinical trials indicate that the beneficial effects of BAL therapy include a reduction of cerebral edema and intracranial pressure, along with the possibility of spontaneous recovery in some cases. Enhancements to the BAL such as increasing the mass of viable and metabolically active hepatocytes are likely to be associated with greater efficacy in future clinical trials.
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