The severity of the clinical situation for patients awaiting liver transplant depends on the conditions induced by the liver disease, which trigger a series of extrahepatic system alterations requiring prompt correction to improve the patient's preoperative condition. In the pre-terminal stage of liver cirrhosis, the patient's general condition is partly due to toxemia caused by loss of blood purification functions and also to liver synthetic deficits. In this study we describe our experience with extracorporeal support techniques, both from the blood purification standpoint and from biosynthesis. This experience represents an historic overview of the techniques involved in for construction of an "artificial liver." The aim of this work was to provide a summary of our clinical findings and current methods in extracorporeal liver support with the goal of improving the clinical status potential transplant patients.