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Molecular adsorbent recirculating system (MARS).

H K Tan1

  • 1Department of Renal Medicine, Singapore General Hospital, Singapore. hankhim@lycos.com

Annals of the Academy of Medicine, Singapore
|June 4, 2004
PubMed
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Molecular adsorbent recirculating system (MARS) is a safe and effective tool for treating fulminant hepatic failure (FHF). Further research is needed to define its role in other liver conditions and optimize treatment protocols.

Area of Science:

  • Hepatology
  • Critical Care Medicine
  • Nephrology

Background:

  • Fulminant hepatic failure (FHF) leads to toxic metabolite accumulation, causing severe clinical manifestations like hepatic encephalopathy and acute renal failure.
  • Molecular adsorbent recirculating system (MARS) is an albumin liver dialysis technique used as a bridge to liver transplantation in FHF patients.

Purpose of the Study:

  • To review the clinical use and technical aspects of MARS in liver failure.
  • To identify current knowledge gaps regarding MARS efficacy in various liver conditions.

Main Methods:

  • A comprehensive review of peer-reviewed journals and monographs on MARS and liver failure.

Main Results:

  • MARS effectively removes water-soluble and protein-bound toxins, ameliorating biochemical and clinical signs of FHF, including cerebral edema.

Related Experiment Videos

  • MARS shows potential benefits in acute-on-chronic liver failure (AoCLF) and less severe acute liver failure (ALF), but its impact on disease progression is uncertain.
  • Unresolved issues include optimal timing, initiation parameters, and intensity (continuous vs. intermittent) of MARS therapy.

    • Conclusions:

    • MARS is a safe and effective homeostatic tool for FHF, aiding in biochemical and clinical stabilization.
    • Further studies are required to establish MARS's role in less severe ALF, multi-organ failure, and AoCLF.
    • Comparative studies between MARS and bio-artificial liver devices are needed to define optimal treatment strategies for the full spectrum of ALF.