The results of serial determinations of serum hyaluronan indicate a prognostic value in progressive liver damage. In primary biliary cirrhosis and in cirrhotic alcoholic liver diseases serum hyaluronan level discriminates between early and advanced disease. In alcoholic liver disease serum hyaluronan can be applied as assessment of haemodynamic changes. Serum hyaluronan is of use as a non-invasive index of liver fibrosis in chronic viral hepatitis. A reversible defect in the hyaluronan receptor of the hepatic endothelial cells was suggested following studies on paracetamol-induced acute liver damage. In liver transplantation, graft function can be predicted by determination of the venous effluent of hyaluronan.