Preliminary Results of a Phase I Trial Evaluating a Noncell Based Extracorporeal Hepatic Support Device

Awad, Samir S.; Swaniker, Fresca; Alarcon, William; Posner, Steven; Haft, Jonathan W.; Bartlett, R. H.

doi:10.1097/00002480-200003000-00277

Cited by 3 publications

(5 citation statements)

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“…Protein synthesis improved during the treatment phase, and plasma antithrombin III levels, prothrombin activity, and Factor VII levels were increased. Cholinesterase levels were also increased (31)(32)(33)(34)(35)39).…”

Section: Clinical Effectsmentioning

confidence: 94%

“…These included improvements in mental status, liver detoxification and synthesis functions, hemodynamic status (increase in mean arterial pressure), and kidney function (Table 3). Additional effects not listed in Table 3 included the marked regression of pruritus in patients with AoCHF (Huster D, Berr F, unpublished observa- (31,35,37,39).…”

Section: Clinical Effectsmentioning

confidence: 99%

“…Almost all groups reported smooth safe performance of the MARS technique (31,32,34,35,(37)(38)(39). No adverse events attributable to MARS treatments were documented.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…The removal of bilirubin and bile acids/salts during MARS treatment could therefore decrease the toxic effects that higher concentrations of these compounds exert on liver and kidney function and could thus contribute to improvements in organ function, as observed by different groups (31)(32)(33)(34)(35)(36)39).…”

Section: Removal Of Bilirubin Bile Salts and Bile Acidsmentioning

confidence: 99%

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Extracorporeal Detoxification Using the Molecular Adsorbent Recirculating System for Critically Ill Patients with Liver Failure

Mitzner¹,

Stange²,

Klammt³

et al. 2001

Journal of the American Society of Nephrology

227

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Abstract.Liver failure resulting from different causes and its concomitant complications represent difficult-to-treat conditions with high mortality rates, despite improved therapeutic modalities in intensive care medicine. The accumulation of albumin-bound metabolites that are normally cleared by the liver, such as bilirubin and bile acids, contributes substantially to the development of multiorgan dysfunction in these clinical situations. The molecular adsorbent recirculating system (MARS) represents a cell-free, extracorporeal, liver assistance method for the selective removal of albumin-bound substances. Moreover, it enables the removal of excess water and water-soluble substances via an inbuilt dialysis step. Since 1993, >400 patients have been treated in 53 centers in Europe, the United States, and Asia. Diseases treated with MARS included acute exacerbation of chronic hepatic failure, hepatorenal syndrome, acute hepatic failure, and primary nonfunction/poor function after liver transplantation and major liver resection. Treatments were well tolerated. No severe adverse events were observed. Six- to 8-h MARS treatments resulted in significant (P< 0.05) removal of bilirubin, bile acids, tryptophan, shortand middle-chain fatty acids, aromatic amino acids, and ammonia. Clearance rates for strongly albumin-bound substances were between 10 and 60 ml/min. The removal of albumin-bound toxins resulted in decreases in hepatic encephalopathy, increases in mean arterial pressure, and improvements in kidney and liver function. In the first randomized clinical trial of the MARS method for treatment of the hepatorenal syndrome, significant prolongation of survival was observed for the MARS-treated group. It is concluded that the MARS method can contribute to the treatment of critically ill patients with liver failure and different underlying diseases.

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Section: Clinical Effectsmentioning

confidence: 94%

Section: Clinical Effectsmentioning

confidence: 99%

“…Almost all groups reported smooth safe performance of the MARS technique (31,32,34,35,(37)(38)(39). No adverse events attributable to MARS treatments were documented.…”

Section: Adverse Eventsmentioning

confidence: 99%

Section: Removal Of Bilirubin Bile Salts and Bile Acidsmentioning

confidence: 99%

See 2 more Smart Citations

Extracorporeal Detoxification Using the Molecular Adsorbent Recirculating System for Critically Ill Patients with Liver Failure

Mitzner¹,

Stange²,

Klammt³

et al. 2001

Journal of the American Society of Nephrology

227

View full text Add to dashboard Cite

show abstract

“…Albumin‐bound toxins are subsequently exchanged across a high‐flux membrane (111). Improved hepatic encephalopathy grade, increased synthetic ability with increased serum clotting factor concentrations, improved urine volume, and decreased plasma renin levels have all been demonstrated (112–120). CVVHDF has recently been modified to incorporate an albumin‐based dialysate used in a single‐pass approach and has been found to effectively remove bilirubin.…”

Section: Hepatic Failurementioning

confidence: 99%

Reviews: The Current State of Nonuremic Applications for Extracorporeal Blood Purification

Briglia

2005

Seminars in Dialysis

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Despite the commonly accepted indications for hemodialysis and extracorporeal depuritive techniques, some clinicians have come to rely on blood purification for clinical states where the targeted substance for removal differs from uremic waste products. Over the last decade, a number of studies have emerged to help define the application of extracorporeal blood purification (ECBP) to these "nonuremic" indications. This review describes the application of extracorporeal blood purification in clinical states including sepsis, rhabdomyolysis, congestive heart failure, hepatic failure, tumor lysis syndrome, adult respiratory distress syndrome, intravenous contrast exposure, and lactic acidosis. Additional comments are provided to review existing literature on thermoregulation and osmoregulation, including acute brain injury.

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Cellular and Non-Cellular Liver Assist Devices in Management of Acute and Acute on Chronic Liver Failure

Stange

2020

Liver Failure

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Preliminary Results of a Phase I Trial Evaluating a Noncell Based Extracorporeal Hepatic Support Device

Cited by 3 publications

References 0 publications

Extracorporeal Detoxification Using the Molecular Adsorbent Recirculating System for Critically Ill Patients with Liver Failure

Extracorporeal Detoxification Using the Molecular Adsorbent Recirculating System for Critically Ill Patients with Liver Failure

Reviews: The Current State of Nonuremic Applications for Extracorporeal Blood Purification

Cellular and Non-Cellular Liver Assist Devices in Management of Acute and Acute on Chronic Liver Failure

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