Role of Molecular Adsorbent Recycling System (MARS) in the treatment of patients with acute exacerbation of chronic liver failure

Abstract

SUPPLEMENT nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nWe demonstrated a 65.5 % overall survival rate in eight consecutive patients suffering from acute exacerbation of chronic liver disease following treatment with the MARS detoxication system. This study joins other reports concerning the utility of the MARS system in supporting patients with liver failure. In contrast to the regular methods of hemodiafiltration, this system was designed to remove both low and middle molecular weight water soluble substances as well as albumin bound molecules.Indeed, serum levels of ammonia, as well as bilirubin were significantly reduced following the treatment.

Effect of Prometheus liver assist system on systemic hemodynamics in patients with cirrhosis: A randomized controlled study

“…In the light of this fact, it is interesting that hemodynamic studies have indicated that the MARS system exerts a beneficial influence on CO, SV, SVRI [20][21][22][23] and MAP [20][21][22][23][24][25][26] . The present study cannot demonstrate such beneficial changes, neither in the Prometheus nor in the hemodialysis group; however, there was a significant increase in MAP in the MARS group.…”

Artificial and bioartificial liver devices: present and future

“…MARS does not alter blood cell counts and arterial blood gases and does not generate haemodynamic instability 6. Improvement in mean arterial pressure (MAP), systemic vascular resistance, cardiac output and cerebral blood flow (due to reduced cerebral oedema) have repeatedly been demonstrated 17 31 32 37 38. Improvement in HE grade during MARS treatment has frequently been observed regardless of the aetiology of the liver failure 6 17 21 31 38 39 40 41 42 43.…”

Molecular adsorbent recirculating system is ineffective in the management of type 1 hepatorenal syndrome in patients with cirrhosis with ascites who have failed vasoconstrictor treatment

“…Although several investigators23 34 35 have described the potential beneficial effects of MARS as a treatment of type 1 HRS,22 others have not reported MARS having any effects on renal function,24 especially in patients with advanced cirrhosis.…”