Application of Molecular Adsorbents Recirculating System to remove NO and cytokines in severe liver failure patients with multiple organ dysfunction syndrome.
BACKGROUND
Molecular Adsorbents Recirculating System (MARS) is a new promising artificial liver support therapy, the aim of this study was to assess the effectiveness of MARS to remove nitrous oxide (NO) and cytokines in severe liver failure patients with multiple organ dysfunction syndrome (MODS).


METHODS
Sixty single MARS treatments were performed with length of 6-24 h on 24 severe liver failure patients (18 males/6 females) with MODS.


RESULTS
The MARS therapy was associated with a significant removal of NO and certain cytokines such as TNF-alpha, IL-6, IL-8, and INF-gamma, together with marked reduction of other non-water-soluble albumin bound toxins and water-soluble toxins, these were associated with a improvement of the patients' clinical conditions including hepatic encephalopathy, deranged hemodynamic situation and as well as renal and respiratory function, thus resulted into marked decrease of Sequential Organ Failure Assessment (SOFA) score and improved outcome: nine patients were able to be discharged from the hospital or bridged to successful liver transplantation, the overall survival of 24 patients was 37.5%.


CONCLUSIONS
We can confirm the positive therapeutic impact and safety to use MARS on liver failure patients with MODS associated with elevated levels of NO and cytokines.
Guo
Li-Min
LM
ICU & Artificial Liver Support Center, Beijing DiTan Hospital, Beijing, PR 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
Yun
Y
He
Zhong-Ping
ZP
Wang
Min-Min
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016207:Cytokines / Q000097:blood*; 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*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000628:therapy*; D009609:Nitrous Oxide / Q000097:blood*; D006435:Renal Dialysis; D012720:Severity of Illness Index; D016060:Sorption Detoxification; D014118:Toxins, Biological / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D014118:Toxins, Biological; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; D009609:Nitrous Oxide