Cell therapy, in particular liver cell transplantation, holds great therapeutic 
potential and is partially hindered by the high rate of apoptosis during cell 
isolation, cryopreservation and engraftment. Apoptosis triggered by cell 
detachment from the extracellular matrix, which occurs during hepatocyte 
isolation, is a phenomenon termed "anoikis". It's importance in the normal 
physiologic development of the human body, as well as in disease states, has 
been described. Cancer cells harbor anoikis resistance allowing spread to occur. 
Activation of the protein Fas associated death domain/MORT1 initiates the 
apoptosis cascade, with further downstream activation of caspase 8, Bid, 
cytochrome c and the executioner caspases. The anti-apoptotic protein family 
(bcl-2) and integrins, in particular beta 1 integrin, balance the pro apoptotic 
signals. The family of caspase enzymes, currently including 14 members, is 
subdivided by the prodomain length, specific substrate and phylogenetic 
analysis, and plays a crucial role in the apoptotic cascade. Therefore, 
understanding the molecular biology of apoptosis and specifically the "form" 
termed anoikis, has advanced clinical implications in cancer and cell therapy 
research.