Outcome from molecular adsorbent recycling system (MARS<sup>™</sup>) liver dialysis following drug‐induced liver failure

Lee, Kang-Hoe; Lee, Margaret Kwee-Hiang; Sutedja, Dede Selamat; Lim, Seng-Gee

doi:10.1111/j.1478-3231.2005.01091.x

Cited by 42 publications

(23 citation statements)

References 32 publications

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“…The fact that these patients were, therefore, in better clinical condition prior to LTX might contribute to the high overall survival of transplanted patients. The favorable effect of MARS treatment on laboratory parameters, as we observed, has also been reported in many small, uncontrolled studies [26,27,[37][38][39][40][41][42][43][44] . However, the improvement in laboratory values alone might be only temporary and does not necessarily predict a favorable outcome.…”

Section: Discussionsupporting

confidence: 65%

Survival predictors in patients treated with a molecular adsorbent recirculating system

Kantola¹,

Koivusalo²,

Parmanen³

et al. 2009

WJG

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AIM:To identify prognostic factors for survival in patients with liver failure treated with a molecular adsorbent recirculating system (MARS). METHODS:MARS is a liver-assisting device that has been used in the treatment of liver failure to enable native liver recovery, and as a bridge to liver transplantation (LTX). We analyzed the 1-year outcomes of 188 patients treated with MARS, from 2001 to 2007, in an intensive care unit specializing in liver disease. Demographic, clinical and laboratory parameters were recorded before and after each treatment. One-year survival and the number of LTXs were recorded. Logistic regression analysis was performed to determine factors predicting survival. RESULTS:The study included 113 patients with acute liver failure (ALF), 62 with acute-on-chronic liver failure (AOCLF), 11 with graft failure (GF), and six with miscellaneous liver failure. LTX was performed for 29% of patients with ALF, 18% with AOCLF and 55% with GF. The overall 1-year survival rate was 74% for ALF, 27% for AOCLF, and 73% for GF. The poorest survival rate, 6%, was noted in non-transplanted patients with alcohol-related AOCLF and cirrhosis, whereas, patients with enlarged and steatotic liver had 55% survival. The etiology of liver failure was the most important predictor of survival (P < 0.0001). Other prognostic factors were encephalopathy (P = 0.001) in paracetamol-related ALF, coagulation factors (P = 0.049) and encephalopathy (P = 0.064) in non-paracetamol-related toxic ALF, and alanine aminotransferase (P = 0.013) and factor V levels (P = 0.022) in ALF of unknown etiology. CONCLUSION:The etiology of liver disease was the most important prognostic factor. MARS treatment appears to be ineffective in AOCLF with end-stage cirrhosis without an LTX option.

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Section: Discussionsupporting

confidence: 65%

Survival predictors in patients treated with a molecular adsorbent recirculating system

Kantola¹,

Koivusalo²,

Parmanen³

et al. 2009

WJG

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“…Hepatotoxic drugs and herbal indigenous medicines are important causes for liver failure in the Asia-Pacific region [25,26].…”

Section: Definition Of Aclfmentioning

confidence: 99%

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)

et al. 2008

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The Asian Pacific Association for the Study of the Liver (APASL) set up a working party on acute-on-chronic liver failure (ACLF) in 2004, with a mandate to develop consensus guidelines on various aspects of ACLF relevant to disease patterns and clinical practice in the Asia-Pacific region. Experts predominantly from the Asia-Pacific region constituted this working party and were requested to identify different issues of ACLF and develop the consensus guidelines. A 2-day meeting of the working party was held on January 22-23, 2008, at New Delhi, India, to discuss and finalize the consensus statements. Only those statements that were unanimously approved by the experts were accepted. These statements were circulated to all the experts and subsequently presented at the Annual Conference of the APASL at Seoul, Korea, in March 2008. The consensus statements along with relevant background information are presented in this review.

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“…It was suggested that MARS may be of particular benefit in some specific causes of acute live failure (eg, Wilson's disease and Amanita phalloides poisoning) [44,45]. In a series of 13 patients who had drug-induced acute liver failure treated with MARS, however, the mortality rate was 85% [46].…”

Section: Liver Support Devicesmentioning

confidence: 99%

Modern Management of Acute Liver Failure

O’Grady

2007

Clinics in Liver Disease

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Outcome from molecular adsorbent recycling system (MARS^™) liver dialysis following drug‐induced liver failure

Abstract: MARS liver dialysis in a setting without timely liver transplantation is associated with a poor outcome. It does, however, provide a window of time for consideration of living donors in the setting of limited cadaveric donors.

Cited by 42 publications

References 32 publications

Survival predictors in patients treated with a molecular adsorbent recirculating system

Survival predictors in patients treated with a molecular adsorbent recirculating system

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)

Modern Management of Acute Liver Failure

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Outcome from molecular adsorbent recycling system (MARS™) liver dialysis following drug‐induced liver failure

Abstract: MARS liver dialysis in a setting without timely liver transplantation is associated with a poor outcome. It does, however, provide a window of time for consideration of living donors in the setting of limited cadaveric donors.

Cited by 42 publications

References 32 publications

Survival predictors in patients treated with a molecular adsorbent recirculating system

Survival predictors in patients treated with a molecular adsorbent recirculating system

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)

Modern Management of Acute Liver Failure

Contact Info

Product

Resources

About

Outcome from molecular adsorbent recycling system (MARS^™) liver dialysis following drug‐induced liver failure