[Artificial liver support. Literature review]

Area of Science:

• Hepatology and Nephrology
• Artificial Organ Support Systems

Background:

• Liver failure leads to the accumulation of toxic substances, necessitating advanced treatment modalities.
• Current treatments for liver failure have limitations, driving the need for innovative supportive therapies.

Purpose of the Study:

• To systematically review the efficacy and safety of extracorporeal albumin dialysis (EAD) systems in patients with liver failure.
• To evaluate specific EAD systems, including Molecular Adsorbent Recirculation System (MARS), Prometheus, and Biologic-DT.

Main Methods:

• Systematic review of controlled trials.
• Screening of 436 references to identify 10 relevant controlled trials.
• Analysis of interventions focusing on biochemical and clinical outcomes, and safety assessments.

Main Results:

• EAD systems demonstrated significant reduction in key toxic parameters such as bilirubin and creatinine.
• Some studies indicated clinical benefits, including improvements in hepatic encephalopathy and patient survival.
• Adverse events were reported in a limited number of studies, with coagulation disorders being the most frequent concern.

Conclusions:

• Albumin dialysis-based systems show promise in reducing toxic load and improving clinical outcomes in liver failure.
• Further rigorous studies are essential to comprehensively evaluate long-term survival benefits and standardize the reporting of adverse events.