[Development of extracorporeal blood purification methods: Molecular Adsorbent Recirculating System (MARS) for...

The Molecular Adsorbent Recirculating System (MARS) clears the blood from catabolites that either occur free in the plasma water (through dialysis), such as uremic toxins and ammonia, or are bound by albumin, such as hepatic toxins. The latter are transferred from the albumin in the blood to the albumin circulating in a closed loop where toxins are removed by adsorption on resins (charcoal and ion-exchange resin). The efficacy of this extracorporeal blood purification method in the treatment of acute or acute-on-chronic liver failure (also associated with renal failure) has been demonstrated in numerous studies. Fifty-one patients, 5 affected by acute liver failure and 46 by acute-onchronic liver failure (8 of them with additional renal failure) were treated with MARS. The results demonstrated that the method, which effectively removes ammonia, bilirubin, bile acids and uremic toxins, reduces the blood concentration of these molecules. It thereby improves the patient's clinical condition and biochemical parameters including cholinesterase, alkaline phosphatase and prothrombin activity, eliminating, in addition, the drug-refractory pruritus that is a very frequent symptom in cholestatic liver disease. These results agree with those reported in the literature concerning the efficacy of MARS in the replacement of the detoxifying function of kidneys and liver.