[The treatment of molecular adsorbents recirculating system artificial liver in severe liver failure patients with multiple organ dysfunction syndrome].
OBJECTIVE
To evaluate the effectiveness and mechanisms of molecular adsorbents recirculating system (MARS) treatment in severe liver failure patients with multiple organ dysfunction syndrome (MODS).


METHODS
60 single MARS treatments were performed for 6 - 24 hours on 24 severe liver failure patients with MODS.


RESULTS
MARS therapy was associated with marked reduction of albumin bound toxins and water soluble toxins, together with a significant removal of NO and certain cytokines, such as TNF-alpha, IL-6, IL-8, and INF-gamma. These were associated with a improvement of the patients' clinical conditions including hepatic encephalopathy, deranged hemodynamic situation, as well as renal and respiratory function, thus resulted into marked decrease of sequential organ failure assessment (SOFA) score (from 9.72+-1.89 to 6.98+-2.34), and improving outcome: 9 patients were able to be discharged from the hospital or bridged to successful liver transplantation. The overall survival rate of 24 patients was 37.5%.


CONCLUSIONS
There is positive therapeutic impact and safety to use MARS on liver failure patients with MODS. The effectiveness of MARS is correlated with reducing the levels of NO and cytokines, except for completely removing of accumulated toxins in liver failure patients.
Guo
Li-min
LM
Infensive Care Unit or Artificial Liver Support Center, Beijing Ditan Hospital, Beijing 100011, China.
Liu
Jing-yuan
JY
Xu
Dao-zhen
DZ
Li
Bao-shun
BS
Han
Hao
H
Wang
Ling-hang
LH
Zhang
Wei-yan
WY
Lu
Lian-he
LH
Guo
Xia
X
Sun
Feng-xia
FX
Zhang
Hong-yu
HY
Liu
Xiao-dong
XD
Zhang
Jian-ping
JP
Yao
Jun
J
He
Zhong-ping
ZP
Wang
Min-min
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019149:Bioreactors; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D017114:Liver Failure, Acute / Q000097:blood / Q000628:therapy*; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000628:therapy*; D009569:Nitric Oxide / Q000097:blood; D016060:Sorption Detoxification / Q000295:instrumentation / Q000379:methods; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D007371:Interferon-gamma