The management of patients for end-stage liver disease in the ICU mandates a multidisciplinary approach and intense monitoring. Orthotopic liver transplantation still remains the only definitive therapy. Given the increasing disparity between the number of potential recipients and available cadaver organs, the current challenge is to optimize outcome with the limited resource. In recent years, considerable progress has been made in developing specific and supportive medical measures. Future research should target a better understanding of mechanisms responsible for liver cell death and liver regeneration, as well as developments in xenotransplantation, hepatocyte transplantation, and liver-directed gene therapy.
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