ABSTRACT
Clinical trials showed the minimum efficiency of various detoxifying methods (dialysis, charcoal adsorption, plasma exchange) in terms survival in acute hepatic insufficiency. Attempts were made to provide hepatic functions through ex vivo perfusion of the whole liver and tissue sections, but these methods remain a challenge to immune responses and blood clotting. This led to the development of the extracorporeal liver support systems and early clinical results encouraged further work in this area. The liver support system consists of a bioreactor containing a liver homogenate, a transfer mechanism, and a dialyzer that connects 2 closed contours. The apparatus is connected to the patient's blood system by means of an arteriovenous or venovenous shunt. The contact time of a liver homogenate and a patient's blood in the dialyzer and the diffusion rate of molecules of chemical substances determine the detoxifying and metabolic effects. Laboratory studies have demonstrated that the detoxifying activation method has high effects (increased biotransformation, decreased blood ammonia levels), decreases the intensity of pathological processes, normalizes blood components (higher levels of ATP, glucose, amino acids, vitamin C). Model and experimental studies of the efficiency of the method lead to the conclusion that it is expedient to apply it in medical practice.
