Successful application of MARS therapy in a 7 year-old patient with hepatic chronic rejection and severe cholestatic syndrome.
Liver transplant currently represents the therapeutic method for irreversible acute and chronic liver diseases without any other available therapy. In some cases, before or after liver transplantation, it is necessary to replace the functions of the liver. We report the case of a 7 year-old female patient with type I glycogenosis who was transplanted in July 2001 using living-related donor transplantation and who developed chronic rejection two months later. In this case, we used MARS (Molecular Adsorbents Recirculating System) detoxification therapy to optimise the patient's clinical and biological status and to create a bridge that allowed the patient's survival until retransplantation was available. The therapy was well tolerated, with no major incidents. We noted favourable clinical effects and significant improvement in serum bilirubin level, urea nitrogen level and serum creatinine level. We consider that MARS treatment is a temporary solution for patients with acute and acute-on-chronic liver failure, indicated in those cases with real chances of recovery of the hepatic functions or in patients on the liver transplantation waiting list.
Voiculescu
Mihai
M
Fundeni Clinical Institute, Department of Internal Medicine and Nephrology, Sos. Fundeni no. 258, 72437 Bucharest, Romania.
Ioanitescu
Simona
S
Rusu
Elena
E
Micu
Diana
D
Mihaila
Mariana
M
Micu
Laurentiu
L
D002648:Child; D005260:Female; D006084:Graft Rejection; D006801:Humans; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D012086:Reoperation; D016060:Sorption Detoxification / Q000379:methods*; D016896:Treatment Outcome; D014850:Waiting Lists