Application of MARS artificial liver support as bridging therapy before split liver retransplantation in a 15-month-old child.
Molecular Adsorbent Recirculating System (MARS) is a blood-filtering system designed to provide biological artificial liver support. We describe its use in a small child to illustrate its effectiveness and practicality in this age group. A 15-month-old male underwent split liver transplantation for acute liver failure following bone marrow transplantation. After development of graft dysfunction we instituted MARS-dialysis. MARS therapy led to a dramatic fall in serum bilirubin and transaminases. Liver synthetic function was not affected. This was accompanied by a stabilization of the patients clinical condition until repeat split liver transplantation was performed 2 weeks after the first graft. MARS-dialysis is practical in the small child. In this case, it did not provide definitive treatment but was an excellent bridging therapy before retransplantation.
Hommann
M
M
Klinik für Allgemeine und Viszerale Chirurgie, Friedrich-Schiller-Universität Jena, Deutschland. hommann@bach.med.uni-jena.de
Kasakow
L B
LB
Geoghegan
J
J
Kornberg
A
A
Schotte
U
U
Fuchs
D
D
Hermann
J
J
Zintl
F
F
Scheele
J
J
D004867:Equipment Design; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019164:Liver, Artificial; D008297:Male; D012086:Reoperation; D016060:Sorption Detoxification / Q000295:instrumentation / Q000379:methods*