Cytokine level modifications: molecular adsorbent recirculating system versus standard medical therapy

Area of Science:

• Hepatology
• Critical Care Medicine
• Immunology

Background:

• Acute-on-chronic liver failure (ACLF) is characterized by a systemic inflammatory response with a proinflammatory cytokine profile.
• This inflammatory state drives the progression from stable cirrhosis to ACLF.

Purpose of the Study:

• To evaluate changes in cytokines related to liver inflammation and regeneration.
• To compare the efficacy of Molecular Adsorbent Recirculating System (MARS) versus standard medical therapy (SMT) in ACLF patients.

Main Methods:

• 15 ACLF patients received MARS treatment (8-hour sessions).
• 15 ACLF patients received SMT.
• Patients were monitored for 30 days with 3-month survival follow-up.

Main Results:

• MARS group showed significant changes in IL-6, IL-1, IL-10, and TNF-alpha, with improved hepatocyte growth factor.
• MARS group achieved 60% survival at 3 months.
• SMT group showed only a significant change in TNF-alpha, with 30% survival at 3 months.

Conclusions:

• MARS liver support effectively addresses the pathophysiology of acute liver failure (ALF).
• MARS may enhance spontaneous liver recovery or serve as a bridge to liver transplantation.