title: MARS therapy, the bridging to liver retransplantation - Three cases from the Hungarian liver transplant program.
abstract: Besides orthotopic liver transplantation (OLT) there is no long-term and effective replacement therapy for severe liver failure. Artificial extracorporeal liver supply devices are able to reduce blood toxin levels, but do not replace any synthetic function of the liver. Molecular adsorbent recirculating system (MARS) is one of the methods that can be used to treat fulminant acute liver failure (ALF) or acute on chronic liver failure (AoCLF). The primary non-function (PNF) of the newly transplanted liver manifests in the clinical settings exactly like acute liver failure. MARS treatment can reduce the severity of complications by eliminating blood toxins, so that it can help hepatic encephalopathy (HE), hepatorenal syndrome (HRS), and the high rate mortality of cerebral herniation. This might serve as a bridging therapy before orthotopic liver retransplantation (reOLT). Three patients after a first liver transplantation became candidate for urgent MARS treatment as a bridging solution prior to reOLT in our center. Authors report these three cases, fo-cusing on indications, MARS sessions, clinical courses, and final outcomes.
authors.affiliation: Clinic of Transplantation and Surgery, Semmelweis University Budapest Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Pőcze
authors.forename: János
authors.initials: J
authors.lastname: Fazakas
authors.forename: Gergely
authors.initials: G
authors.lastname: Zádori
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.forename: Eszter
authors.initials: E
authors.lastname: Dabasi
authors.forename: Tamás
authors.initials: T
authors.lastname: Mándli
authors.forename: László
authors.initials: L
authors.lastname: Piros
authors.forename: Anikó
authors.initials: A
authors.lastname: Smudla
authors.forename: Tamás
authors.initials: T
authors.lastname: Szabó
authors.forename: Eva
authors.initials: E
authors.lastname: Toronyi
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Tóth
authors.forename: Gellért
authors.initials: G
authors.lastname: Tőzsér
authors.forename: Gyula
authors.initials: G
authors.lastname: Végső
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
keywords: MARS therapy; liver failure; retransplantation