title: Randomized controlled study of plasma exchange combined with molecular adsorbent re-circulating system for the treatment of liver failure complicated with hepatic encephalopathy.
abstract: OBJECTIVE
  To evaluate the use of plasma exchange (PE) combined with the molecular adsorbent re-circulating system (MARS) for the treatment of liver failure complicated with hepatic encephalopathy.
  
  
  METHODS
  A prospective randomized controlled study was conducted to compare the therapeutic effect of MARS treatment (MARS group, n=60) with that of PE combined with MARS treatment (PE+MARS group, n=60) in patients with liver failure complicated with hepatic encephalopathy.
  
  
  RESULTS
  The serum total bilirubin and blood ammonia levels were significantly decreased compared with pretreatment levels after 3 days of both the MARS treatment (p=0.0001, p<0.001) and PE+MARS treatment (both p<0.0001) and the Glasgow coma scale score was significantly increased (both p<0.0001). The 30-day mortality rate was 10.0% (6/60) in the MARS group and 11.7% (7/60) in the PE + MARS group. The per capita cost of treatment was significantly lower in the PE + MARS group than in the MARS group (p=0.0003).
  
  
  CONCLUSIONS
  Both MARS and PE + MARS therapy can safely and effectively be used to treat liver failure complicated with hepatic encephalopathy, but PE + MARS therapy reduces serum total bilirubin level more effectively and is more cost-effective.
authors.affiliation: Department of Infectious Diseases, Central South University, Changsha, China.
authors.forename: Yu-Kun
authors.initials: YK
authors.lastname: Huang
authors.forename: De-Ming
authors.initials: DM
authors.lastname: Tan
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xie
authors.forename: Xue-Gong
authors.initials: XG
authors.lastname: Fan
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.forename: Zheng-Bo
authors.initials: ZB
authors.lastname: Liu
authors.forename: Sha-Ling
authors.initials: SL
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000641:Ammonia / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001794:Blood Pressure; D005112:Extracorporeal Circulation / Q000009:adverse effects; D005260:Female; D015600:Glasgow Coma Scale; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000628:therapy*; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000009:adverse effects; D016060:Sorption Detoxification / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000641:Ammonia; D001663:Bilirubin