Thermodynamics studies the transformations of energy occurring in open systems. Living systems, with particular reference to cells, are complex systems in which energy transformations occur. Thermo-electro-chemical processes and transports occur across their border, the cells membranes. These processes take place with important differences between healthy and diseased states. In particular, different thermal and biochemical behaviours can be highlighted between these two states and they can be related to the energy transformations inside the living systems, in particular the metabolic behaviour. Moreover, living systems waste heat. This heat is the consequence of the internal irreversibility. Irreversibility is effectively studied by using the Gouy-Stodola theorem. Consequently, this approach can be introduced in the analysis of the states of living systems, in order to obtain a unifying approach to study them. Indeed, this approach allows us to consider living systems as black boxes and analyze only the inflows and outflows and their changes in relation to the modification of the environment, so information on the systems can be obtained by analyzing their behaviour in relation to the modification of external perturbations. This paper presents a review of the recent results obtained in the thermodynamics analysis of cell systems.