Molecular Adsorbents Recirculating System: clinical experience in patients with acute and acute on chronic liver failure

Introduction

The aim of this study is to evaluate the effect of treatment with the Molecular Adsorbents Recirculating System (MARS) in liver failure patients.

Materials and methods

In 28 patients (median age, 50.57 years), 12 cases were of acute liver failure and 16 cases of acute on chronic liver failure, 56 times of 6–8 hour MARS intermittent treatments were performed without any major adverse events.

Results

Significant decreases in serum total bilirubin (31.7%), conjugated bilirubin (29.15%), bile acid (35.91%) and ammonia (53.68%) were observed (P < 0.01), single treatments contributed to the marked improvement of coagulapathy (prothrombin time decreased from 32.37 ± 9.96 s to 21.82 ± 10.39 s, P < 0.01), and most patients (24/28, 85.7%) achieved a remarkable symptomatic recovery after the single treatment. The 30-day hospital survival rate for the 28 liver failure patients was 71.4% (20/28): two patients of acute liver failure recovered, eight cases of acute on chronic liver failure improved and were discharged, 10 patients were successfully bridged to liver transplantation, and eight cases died of multiorgan failure.

Conclusion

It is concluded that the MARS method can serve as an optimistic treatment for liver failure patients with improved immediate survival rate and inspiring bridging support to liver transplantation.