Experience of Mars therapy with and without transplantation in 101 patients with liver insufficiency.
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.
Koivusalo
A-M
AM
Department of Anesthesiology and Intensive Care, Helsinki University Hospital, FIN-0029 HUCH Helsinki, Finland. anna-maria.koivusalo@hus.fi
Vakkuri
A
A
Höckerstedt
K
K
Isoniemi
H
H
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
D000410:Alanine Transaminase; D001663:Bilirubin