title: [The treatment of molecular adsorbents recirculating system artificial liver in severe liver failure patients with multiple organ dysfunction syndrome].
abstract: 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.
authors.affiliation: Infensive Care Unit or Artificial Liver Support Center, Beijing Ditan Hospital, Beijing 100011, China.
authors.forename: Li-min
authors.initials: LM
authors.lastname: Guo
authors.forename: Jing-yuan
authors.initials: JY
authors.lastname: Liu
authors.forename: Dao-zhen
authors.initials: DZ
authors.lastname: Xu
authors.forename: Bao-shun
authors.initials: BS
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Han
authors.forename: Ling-hang
authors.initials: LH
authors.lastname: Wang
authors.forename: Wei-yan
authors.initials: WY
authors.lastname: Zhang
authors.forename: Lian-he
authors.initials: LH
authors.lastname: Lu
authors.forename: Xia
authors.initials: X
authors.lastname: Guo
authors.forename: Feng-xia
authors.initials: FX
authors.lastname: Sun
authors.forename: Hong-yu
authors.initials: HY
authors.lastname: Zhang
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Liu
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Yao
authors.forename: Zhong-ping
authors.initials: ZP
authors.lastname: He
authors.forename: Min-min
authors.initials: MM
authors.lastname: Wang
mesh_terms: 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
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D007371:Interferon-gamma