title: Experience of Mars therapy with and without transplantation in 101 patients with liver insufficiency.
abstract: Liver support devices are used to treat life-threatening organ dysfunction until a hepatic graft is available or recovery of the native liver. We used a blood purification system--molecular adsorbent recycling system (MARS)--that is based on removal of both protein-bound and water-soluble substances and toxins. Within 2.5 years we treated 101 patients, who were stratified to three subgroups: acute liver failure (ALF; n = 56), acute decompensation in chronic liver failure (AcOCh; n = 35) and liver graft failure (n = 10). MARS seems to be a promising therapy for ALF, allowing the patient's own liver to recover or to gain enough time to find a liver graft. The most promising results, namely the highest number of livers to recovery were observed among acute patients with liver failure due to a toxic etiology. However, we did not discover much benefit of MARS for patients with AcOCh without liver transplantation.
authors.affiliation: Department of Anesthesiology and Intensive Care, Helsinki University Hospital, FIN-0029 HUCH Helsinki, Finland. anna-maria.koivusalo@hus.fi
authors.forename: A-M
authors.initials: AM
authors.lastname: Koivusalo
authors.forename: A
authors.initials: A
authors.lastname: Vakkuri
authors.forename: K
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: H
authors.initials: H
authors.lastname: Isoniemi
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005112:Extracorporeal Circulation; D006801:Humans; D008107:Liver Diseases / Q000145:classification / Q000628:therapy; D017093:Liver Failure; D008111:Liver Function Tests; D016031:Liver Transplantation; D016060:Sorption Detoxification / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000410:Alanine Transaminase; D001663:Bilirubin