Pre-transplant optimization by Molecular Adsorbent Recirculating System in patients with severely decompensated chronic liver disease.
BACKGROUND
The outcome of liver transplantation (LT) is influenced by the recipient's clinical condition. In a retrospective observational study, we evaluated the role of pre-LT Molecular Adsorbent Recirculating System (MARS) treatment in improving the clinical status and thereby the outcome of patients with chronic liver disease and severe hepatic decompensation.


METHODS
Between March 2002 and September 2006, 70 patients with end-stage chronic liver disease underwent living-donor LT (LDLT). Of these, 9 (13%) patients with severely decompensated liver function (serum bilirubin> 350 micromol/L [20 mg/dL] and/or hepatic encephalopathy > or = grade 2) received pre-LT MARS treatment.


RESULTS
The median MELD score was 33 (range, 26-47). A median of 2 (range, 1-6) sessions (8 hour/session) of MARS dialysis was performed per patient. MARS treatment was associated with reduction in serum bilirubin, creatinine and ammonia levels and no procedure-related complications.


CONCLUSIONS
Pre-LT MARS is well tolerated and results in reduction of jaundice and improvement in renal function and may be useful in the management of patients with severe hepatic decompensation.
Wagholikar
Gajanan D
GD
Asian Center for Liver Diseases and Transplantation, Gleneagles Hospital, Singapore.
Lee
Kang-Hoe
KH
Pandey
Durgatosh
D
Leong
See-Odd
SO
Singh
Ranjodh
R
Tan
Kai-Chah
KC
D000328:Adult; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology / Q000628:therapy*; D016031:Liver Transplantation; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies