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Updated: Jul 4, 2026
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Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
Mars and Prometheus: our clinical experience in acute chronic liver failure
S Faenza1, O Baraldi, M Bernardi
1Department of Surgery, Intensive Care and Transplantation, Policlinico Sant'Orsola, Bologna, Italy. stefano.faenza@unibo.it
Transplantation Proceedings
|June 17, 2008
Summary
Molecular Adsorbent Recirculating System (MARS) and Prometheus treatments for acute or chronic liver failure (AoCLF) showed good purification efficiency. However, survival rates were low and inversely proportional to MELD scores, suggesting limited benefit.
Area of Science:
- Hepatology
- Nephrology
- Critical Care Medicine
Background:
- Two blood purification systems, MARS and Prometheus, are used for acute or chronic liver failure (AoCLF).
- Patient selection criteria differed between the MARS and Prometheus groups.
- Treatment sessions were standardized at a minimum of 6 hours, repeated every 24-36 hours.
Purpose of the Study:
- To compare the efficacy and outcomes of MARS and Prometheus treatments in AoCLF patients.
- To evaluate the impact of these treatments on transplant listing and patient survival.
- To assess the utility of these systems in primary nonfunction (PNF) and secondary liver insufficiency cases.
Main Methods:
- MARS group: Accessed based on lack of response to standard medical treatment after 72 hours.
- Prometheus group: Accessed based on multicenter Helios protocol criteria for AoCLF, PNF, and secondary liver insufficiency.
- Both groups underwent treatment sessions of at least 6 hours, repeated every 24-36 hours.
Main Results:
- A total of 56 AoCLF patients underwent 278 treatment sessions (191 MARS, 87 Prometheus).
- Both systems demonstrated good purification efficiency.
- 70% of patients on either treatment were reinstated on the transplant list or received grafts.
Conclusions:
- Treatment led to recovery in some patients not destined for transplantation.
- 3-month survival rates were 48.5% for MARS and 33.5% for Prometheus.
- Treatment outcomes were inversely related to MELD scores, and appeared ineffective in PNF and secondary liver insufficiency cases.
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