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Liver disease continues to be a challenge clinically, with 30,000 patients dying each year from liver failure (
1
). Although liver transplantation can successfully treat many patients undergoing liver failure, the scarcity of donor organs severely limits this treatment’s application. For this reason, many investigators are pursuing alternatives to total organ transplantation, from living donors to cell transplantation. One additional approach is the development of a hybrid, bioartificial liver as an extracorporeal device for the temporary treatment of acute liver failure. This approach has demonstrated early success, and may provide an important clinical treatment in the near future. In addition, a bioartificial liver reactor is useful for prolonged in vitro studies of hepatocyte function. This chapter will provide information on the design and use of such a reactor for in vitro applications.