Abbreviations used: ALF -acute liver failure; ADSCs -adipose tissue-derived stem cells; ALB -albumin; CK32 -connexin 32; CYP3A4 -cytochrome P450 subtype 3A4; IDOindoleamine 2,3-dioxygenase; IFN -interferon; IL -interleukin; GAPDH -glyceraldehyde-3-phosphate dehydrogenase; MSCs -mesenchymal stem cells; OFSCs -orbital fat-derived stem cells; PAS -periodic acid-Schiff; TDO2 -tryptophan 2,3-dioxygenase; TNF -tumor necrotic factor Abstract: Preservation of hepatocyte functions in vitro will undoubtedly help the management of acute liver failure. The coculture system may be able to prevent functional decline of hepatocytes. It has already been shown that hepatocytes, when cocultured with bone marrow mesenchymal stem cells, could undergo long-term culture in vitro without loss of functions. In this study, human orbital fat-derived stem cells were isolated and cocultured with rat hepatocytes. When treated with serum from an acute liver failure patient, rat hepatocyte monoculture showed reduction of cell viability and loss of liverspecific functions. However, rat hepatocytes in the coculture system were still able to secret albumin and synthesize urea. IL-6 was significantly elevated in the coculture of rat hepatocyte with orbital fat-derived stem cells, and it might be the key immunoregulator which protects rat hepatocytes against inflammation. Our data confirmed that orbital fat-derived stem cells, or other adipose tissue-derived stem cells, are an ideal candidate to support rat hepatocyte functions in vitro.