A New Procedure for the Removal of Protein Bound Drugs and Toxins

Acute liver failure due to antitubercular therapy: Strategy for antitubercular treatment before and after liver transplantation

“…21 The criterion for LT was the presence of grade 3-4 HE associated with either a factor V level <20% of normal in patients <30 years of age or a factor V level <30% of normal in patients >30 years of age. 18,22,23 On admission, extracorporeal liver support involving a molecular adsorbent recycling system 24,25 or a bioartificial liver was initiated in 3 patients. [25][26][27] After LT, all patients received immunosuppressive therapy according to the standard practice of our center.…”

Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus

“…However, because of the ability of MARS to combine albumin and standard dialysis, the system should be able to remove both forms of acids, at least theoretically. 1 10 and 74. The higher the score, the better the quality of life.…”

Fulminant Hepatic Failure Bridged to Liver Transplantation with a Molecular Adsorbent Recirculating System: A Single-Center Experience

“…Molecular adsorbent recirculating system (MARS) (Teraklin, Aktiengesellschaft, Rostok, Germany) is an artificial liver support system, first introduced into clinical practice in 1993 [1]. In contrast to bio-artificial liver support systems, which replace some of the metabolic and synthetic functions of the liver by means of established hepatocyte or hepatoblastoma cell lines [2], MARS aims only at clearing the blood from metabolic waste products normally metabolized by the liver.…”

“…It is, essentially, a modified dialysis system, employing an albumincontaining dialysate that is recirculated and perfused in-line through charcoal and anion exchanger columns. This effects the removal of albumin-bound toxins like aromatic amino acids and their metabolites, conjugated bilirubin, bile acids, phenols, short and middle chain fatty acids, copper, mercaptans, cytokines, tryptophan, tumor necrosis factor-, interleukin-6, and diazepam together with free solutes like ammonia, creatinine, urea that are removed by standard dialysis [1,3]. Most of the experience with MARS has shown specific efficacy in the treatment of acute-on-chronic hepatic failure, where it improves cerebral blood flow, hemodynamic status, liver and renal function, survival [4][5][6], and intractable pruritus [7].…”