Experience with the Molecular Adsorbents Recirculating System: Chinese results on 149 patients with liver failure based on hepatitis B

Introduction

Liver failure resulting from hepatitis B (HBV) represents difficult-to-treat conditions. Molecular Adsorbents Recirculating System (MARS) liver support is a novel therapy, but few data on patients of HBV are available.

Methods

This report is a review of MARS on patients with liver failure suffered from HBV. Data were extracted from official journals until September 2003; 149 patients with 347 treatments in China were eligible with available detailed data (mean age was 44.3 ± 13.2 [15–80] years, 102 males, average treatments 2.33 per patient).

Results

MARS treatments were associated with a significant reduction of albumin-bound toxins and various cytokines, as well as the water-soluble toxins. Most patients showed a positive response to the therapy, proven by an increase in prothrombin time activity and mean arterial pressure, and a decrease in hepatoencephalo-pathy grade and Child–Turcotte–Pugh index significantly.

Eighty-four patients survived in hospital including those alive from the liver transplantation (56.4%). Survival of the acute liver failure, subacute liver failure and acute on chronic liver failure patients were 62.5%, 66.7% and 54.5%, and acute on chronic liver failure patients formed the majority (121/149–81.2%). Patients in end stage presented the largest among the subgroups of acute on chronic liver failure (65/121, 53.7%), and patients in the early and middle stages gained more favorable outcomes than those in C grade (91.7% and 75% vs 30.8%) (Table 1).

Table 1

Randomized controlled studies in China are ongoing to verify the optimal therapeutic results of MARS.