Therapeutic application of the Molecular Adsorbents Recirculating System in various pathogenic multiple organ dysfunction syndrome patients

Background

The Molecular Adsorbents Recirculating System (MARS) is a new promising artificial liver support therapy. The aim of this study was to assess the effectiveness of MARS to remove nitro oxide (NO) and cytokines in multiple organ dysfunction syndrome (MODS) with severe liver failure patients.

Methods

One hundred and ten single MARS treatments were performed with a length of 6–24 hours on 39 various pathogenic MODS patients (27 male/12 female) (see Table 1).

Table 1

Table 2

Results

The MARS therapy was associated with a significant removal of NO and certain cytokines such as TNF-α, IL-2, IL-6, IL-8, and lipopolysaccharide binding protein (LBP) (see Table 2), together with a marked reduction of other nonwater-soluble albumin-bound toxins and water-soluble toxins. These were associated with an improvement of the patients' clinical conditions including hepatic encephalopathy, deranged hemodynamic situation and renal and respiratory function, thus resulting in a marked decrease of teh Sequential Organ Failure Assessment (SOFA) score and improved outcome: 16 patients were able to be discharged from the hospital or bridged to successful liver transplantation. The overall survival of 39 patients was 41%.

Conclusion

We can confirm the positive therapeutic impact and safety to use MARS on various pathogenic MODS patients associated with elevated levels of NO and cytokines.