Acute hepatic failure (AHF) is a life threatening condition with a high mortality rate. There is a need to buy time, either waiting for the liver to regenerate or waiting for urgent liver transplantation. Different modalities of "liver dialysis" have been used during the last decades but of no true success. However, a new technique has been developed called the MARS (Molecular Adsorbent Recycling System) built upon the same principle as haemodialysis but with the capacity to also remove albumin bound compounds thought to be toxic to the liver. This is a report of our ten first cases, all having AHF and considered for liver transplantation. The survival rate was 7/10 and of the 5 patients in need of 5 or more treatments all but one survived. In these cases the MARS-treatment seemed to have positive effects on the course and outcome of the disease but there are a need for controlled trials to clearly prove the benefit of the treatment.