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Review article: the molecular adsorbents recirculating system (MARS) in liver failure
S Sen1, R P Mookerjee, N A Davies
1Institute of Hepatology, University College London Medical School and University College London Hospitals, UK.
Alimentary Pharmacology & Therapeutics
|November 9, 2002
Summary
The Molecular Adsorbents Recirculating System (MARS) shows promise in removing toxins for liver disease patients. Clinical trials are ongoing to confirm its effectiveness in acute liver failure and graft dysfunction.
Area of Science:
- Hepatology
- Artificial Liver Support Systems
- Nephrology
Background:
- Artificial liver support systems are emerging for acute liver failure and decompensated chronic liver disease.
- The Molecular Adsorbents Recirculating System (MARS) removes albumin-bound toxins like bilirubin and bile acids.
- Clinical data on MARS is limited but shows potential benefits.
Purpose of the Study:
- To evaluate the effectiveness of the Molecular Adsorbents Recirculating System (MARS).
- To assess MARS in patients with acute decompensation of chronic liver disease or acute liver failure.
- To review current clinical experience and ongoing trials for MARS.
Main Methods:
- Utilizes a dialysis technique with an albumin-impregnated membrane.
- Blood is treated against a recirculated albumin-containing solution.
- Analysis of existing pilot studies and preliminary data.
Main Results:
- MARS effectively removes albumin-bound toxins.
- Pilot studies suggest MARS improves liver function and hepatic encephalopathy in chronic liver disease.
- MARS shows potential for improving renal function in hepatorenal syndrome type I.
Conclusions:
- MARS demonstrates efficacy in toxin removal and shows promise in specific liver conditions.
- Further randomized controlled trials are necessary to establish its definitive role in acute liver failure and primary graft dysfunction.
- The clinical utility of MARS is currently under active investigation.