Advances in the application of artificial liver in liver failure

Liver failure is a serious stage in the development of various liver diseases, with rapid progression, critical conditions, and a high mortality rate. Artificial liver can eliminate toxic substances in the body, supplement essential substances, and create opportunities for hepatocyte regeneration and liver function recovery, and in addition, it can also prolong the waiting time for liver transplantation and thus acts as a bridge to liver transplantation. However, the wide application of artificial liver is facing many difficulties nowadays, such as shortage of blood sources, difficulties in cell sources, a lack of satisfactory effects, and high costs, and therefore, artificial liver treatment needs innovation and improvement. New non-bioartificial liver systems developed in recent years, such as double plasma molecular absorption system, molecular absorbent recirculating system, continuous albumin purification system, and plasma diafiltration, can help to achieve a good clinical outcome and meanwhile reduce the amount of plasma used and minimize side effects. Biological artificial liver and hybrid artificial liver systems have the functions of specific detoxification, biosynthesis, and transformation and thus have great potential in clinical application, which is limited by cell source, cell culture, and bioreactor. This article elaborates on the current status and advances in the application of artificial liver in the treatment of liver failure and provides research directions for the development of artificial liver.