AIM:To study the role of hybrid bioartificial liver (HBL) inclearing proinflammatory cytokines and endotoxin in patientswith acute and sub-acute liver failure and the effects of HBLon systemic inflammatory syndrome (SIRS) and multipleorgan dysfunction syndrome (MODS).METHODS:Five cases with severe liver failure (3 acuteand 2 subacute) were treated with HBL.The clinical signsand symptoms,total bilirubin (TBIL),serum ammonia,endotoxin TNF-α IL-6 and prothrombin activity (PTA),cholinesterase (CHE) were recorded before,during and aftertreatment.The end-stage liver disease (MELD) was usedfor the study.RESULTS:Two patients were bridged for spontaneousrecovery and 1 patient was bridged for OLT successfully.Another 2 patients died on d 8 and d 21.The spontaneousrecovery rate was 30.0%.PTA and CHE in all patients weresignificantly increased (P<0.01),while the serum TBIL,endotoxin,TNF-α,IL-6 were decreased.MELD score (mean43.6) predicted 100% deaths within 3 mo before treatmentwith HBL.After treatment with HBL,four out of 5 patientshad decreased MELD scores (mean 36.6).The MELD scorepredicted 66% mortalities.CONCLUSION:The proinflammatory Oltokines (TNFα,IL-6 and endotoxin)can be significantly removed by hybridbioartificial liver and HBL appears to be effective in blockingSIRS and MODS in patients with acute and sub-acute liverfailure.MELD is a reliable measure for predicting short-termmortality risk in patients with end-stage liver disease.Theprognostic result also corresponds to clinical outcome. AIM: To study the role of hybrid bioartificial liver (HBL) inclearing proinflammatory cytokines and endotoxin in patients with acute and sub-acute liver failure and the effects of HBLon systemic inflammatory syndrome (SIRS) and multipleorgan dysfunction syndrome (MODS). METHODS: Five cases with severe liver failure (3 acute and 2 subacute) were treated with HBL.The clinical signsand symptoms, total bilirubin (TBIL), serum ammonia, endotoxin TNF-α IL-6 and prothrombin activity (PTA), cholinesterase , during and aftertreatment.The end-stage liver disease (MELD) was used for the study .RESULTS: Two patients were bridged for spontaneous recovery and 1 patient was bridged for OLT successfully. Another 2 patients died on d 8 and d 21.The. spontaneous recovery rate was 30.0% .PTA and CHE in all patients weresignificantly increased (P <0.01), while the serum TBIL, endotoxin, TNF-α and IL-6 decreased.MELD score (mean43.6) predicted 100% deaths within 3 mo before treatmentwith HBL.After t The MELD score was reduced to 66% mortalities. CONCLUSION: The proinflammatory Oltokines (TNFα, IL-6 and endotoxin) were be removed by hybridbioartificial liver and HBL appears to be effective in blocking SIRS and MODS in patients with acute and sub-acute liver failure. MFD is a reliable measure for predicting short-termmortality risk in patients with end-stage liver disease. The prognostic result also corresponds to clinical outcome.