الفهرس 
Anatomy and Physiiollogy of the Liiver Anatomy of the liverOnly 14 pages are availabe for public view
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Abstract
Liver failure, whether occurring without preexisting liver disease (acute liver failure, ALF) or as an acute episode of decompensation superimposed on a chronic liver disorder (acute-on-chronic liver failure, ACLF), carries high mortality. The lack of the detoxification, metabolic, and regulatory functions of the liver leads to life-threatening complications, including kidney failure, hepatic encephalopathy (HE), cerebral edema, severe hypotension, and susceptibility to infections culminating in multi organ failure.
Mortality of acute liver failure (ALF) remains high despite maximal supportive intensive care treatment. Mortality ranges from 60% to 90% depending on the cause of underlying liver disease.
Survival of patients with ALF caused by acute hepatitis B is 12% to 23% in Western Europe. Since the 1950s, several therapies to assist the failing liver have been introduced. These therapies range from drug treatment to liver support devices and liver transplantation.
At present, standard treatment of ALF is orthotopic liver transplantation (OLT). Emergency OLT is associated with a 1-year survival of 60% to 90%, depending on the cause of ALF and the selection criteria applied for OLT. However, due to the shortage of donor livers, a considerable number of patients with ALF die while on the waiting list.
Despite the efforts to increase the donor liver pool by using split livers, living related donor livers and marginal livers, the availability of donor livers is far less than the demand.
In the United States at the end of 2001, 18,500 patients were waiting for OLT. In this year, 5250 out of 25,750 patients (20%) received a donor liver, whereas 1978 (7.7%) patients with hepatic failure died while waiting for OLT. Of the high urgency patients (c 14% (97 out of 695) died while waiting for a donor liver. The median waiting time for a donor liver in this group was 10 days.
Egypt has the highest countrywide prevalence of hepatitis C virus (HCV) in the world, with an estimated 8–10 million among a population of 68 million having been exposed to the virus and 5–7 million active infections. Only 15–20% of people infected with HCV have an acute liver failure.
Because of these high mortality rates and the increasing waiting times for transplantation over the last years, there has been renewed interest in techniques for providing temporary liver support to bridge the patient with liver failure to OLT or liver regeneration. These techniques can be grossly divided into non biologic and biologic liver support.
Over the past 10 years non-biological liver support has emerged as an exciting tool for the treatment of liver failure, irrespective of it’s an etiology.