Therapeutic application of the molecular adsorbent recirculating system in chronic severe hepatitis patients complicated with multiorgan failure

Objective

The aim of this study is to evaluate the therapeutic effectiveness of the molecular adsorbent recirculating system (MARS) in patients with chronic severe hepatitis complicated with multiorgan failure.

Methods

The present study randomized 82 patients of chronic severe hepatitis complicated with multiorgan failure into a MARS therapy group of 40 patients and the remaining 42 patients of the control group, respectively. One hundred and ten sessions of MARS treatments were performed with an average of 2.75 sessions per patient. All were evaluated clinically by the model for end-stage liver diseases (MELD) and liver function, hemogram, ammonia lever, coagulopathy, BUN and creatinine levels before and after treatment.

Results

MARS therapy resulted in remarkable improvement of the prognosis assessment model of MELD (27.1 ± 2.81 to 19.5 ± 3.66, P < 0.01) and finally benefited the improved survival in the MARS group (19/40, 47.5% vs 10/42, 23.8% of the control group, P < 0.05), clinically presented in significant therapeutic effectiveness in hepatic encephalopathy or brain edema, renal dysfunction, obstinate ascites as well as reversal development of systematic inflammatory response syndrome and improvement of hemodynamic and respiratory function by selective elimination of accumulated metabolic toxins and management of electrolyte, fluid and acid–base balance with a safe record.

Conclusions

MARS therapy can be applied safely as preferable liver support for liver failure patients in therapeutic management for complications and multiorgan failure.