Application of the Molecular Adsorbents Recirculating System in patients with severe chronic viral hepatitis B in middle and end stages

Objective

To summarize and evaluate the treatment effective and survival of the Molecular Adsorbents Recirculating System (MARS) in patients with severe chronic viral hepatitis B (SCH-B) in middle and end stages.

Methods

Sixteen patients with SCH-B in middle and end stages underwent MARS therapy as the MARS treatment group. A retrospective review of 16 patients chosen from previous therapy data, also of SCH-B and clinically matched to the MARS group, were regarded as the standard medical therapy (SMT) group, who had been treated with general methods except MARS. The prognosis of the two groups were studied and the treatment effects on levels of serum total bilirubin, nonconjugated bilirubin and mean arterial pressure (MAP) were observed in the MARS group during a single 6–8 hour MARS treatment.

Results

The single MARS treatment contributed to significant decreases in levels of serum total bilirubin (from 547 ± 187 mmol/l to 312 ± 118 mmol/l, P < 0.05) and nonconjugated bilirubin (379 ± 134 mmol/l to 185 ± 68 mmol/l, P < 0.05), respectively, and MAP was increased from 72 ± 8 mmHg to 81 ± 7 mmHg (P < 0.05) during the MARS therapy. There were statistical differences in prognosis and survival between the two groups: in the SMT group, six of 12 patients in the middle stage survived (50%), while in the MARS group the survival for comparable middle-stage patients was 10/12 (83.3); for the end-stage subgroup comparison, all four patients died in the SMT group but the MARS therapy improved the survival to 25% (1/4) in its four patients. The overall survivals of these two groups with middle-stage and end-stage SCH-B patients were 37.5% for SMT and 68.5% for MARS (P < 0.05).

Conclusions

MARS therapy effectively removed serum bilirubin and other albumin-bound toxins, increased the MAP, and inhibited the hepatocellular necrosis, thus contributing to organ protection.

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