We examined the present status of artificial liver support (ALS) for acute liver failure (ALF) in Japan, by sending the questionnaires about the number of ALF cases, the methods of ALS and the recovery rate of consciousness. ALS comprising plasma exchange and hemodiafiltration (HDF) has been performed in more than 80% of 125 hospitals, but high flow volume HDF (high flow continuous HDF or on-line HDF) in 23 hospitals only. Totally, 50% of patients with fulminant hepatitis and late-onset hepatic failure achieved restoration of consciousness, which was lower than that reported by high flow volume HDF. On-line HDF which reduces the cost and simplifies the procedure is expected to be the main ALS in patients with ALF in the future.
