Related Experiment Videos
Albumin dialysis: single pass vs. recirculation (MARS).
P Peszynski1, S Klammt, E Peters
1Department of Internal Medicine, University of Rostock, Germany.
Liver
|September 11, 2002
Summary
Single Pass Albumin Dialysis (SPAD) is less effective than Molecular Adsorbent Recirculating System (MARS) for removing protein-bound substances in liver failure. MARS offers superior efficacy for bile acids, though SPAD can be improved at significantly higher costs.
Area of Science:
- Hepatology
- Nephrology
- Biomedical Engineering
Background:
- Liver failure leads to the accumulation of protein-bound toxins.
- Molecular Adsorbent Recirculating System (MARS) is an established treatment for removing these substances.
- Single Pass Albumin Dialysis (SPAD) has been proposed as a potential alternative to MARS.
Purpose of the Study:
- To compare the efficacy of SPAD and MARS in removing protein-bound substances in liver failure.
- To evaluate the impact of albumin concentration and dialysate flow rate on SPAD performance.
- To assess the cost-effectiveness and safety of SPAD versus MARS.
Main Methods:
- Performed three SPAD experiments with varying albumin concentrations and flow rates.
- Used human plasma spiked with bilirubin, sulfobromophthalein (BSP), and bile acids (BA).
- Conducted standard MARS experiments and calculated clearances for bilirubin, BSP, and BA.
Main Results:
- MARS demonstrated higher efficacy in removing bile acids compared to SPAD.
- Increasing albumin concentration or flow rate in SPAD improved efficacy but substantially increased costs.
- MARS was found to be safer due to the removal of stabilizers present in commercial albumin solutions.
Conclusions:
- MARS is a more effective albumin dialysis method for critical substances like bile acids.
- Significant cost increases are required to enhance SPAD's efficacy.
- MARS offers a safer and more effective approach for managing protein-bound toxins in liver failure.