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Updated: May 17, 2026
09:29
Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts
Published on: August 13, 2014
Molecular adsorbent recirculating system technique for liver failure due to cardiogenic shock
Armin Zittermann1, Markus Engel, Sigrid Hohnemann
1Heart Center NRW, Clinic of Cardiothoracic Surgery, Bad Oeynhausen, Germany.
The Thoracic and Cardiovascular Surgeon
|October 12, 2012
Summary
Clinical outcomes for liver failure in cardiogenic shock patients are poorly understood. Molecular adsorbent recirculating system (MARS) treatment showed high in-hospital mortality, with sepsis-related Organ Failure Assessment score predicting survival.
Area of Science:
- Cardiology
- Hepatology
- Critical Care Medicine
Background:
- Clinical outcomes for patients with liver failure secondary to cardiogenic shock are not well-documented.
- Liver dysfunction is a known complication in cardiogenic shock, impacting patient prognosis.
Purpose of the Study:
- To analyze the clinical outcomes of patients with cardiogenic shock and liver failure treated with the molecular adsorbent recirculating system (MARS).
- To identify potential risk factors for survival in this patient population.
Main Methods:
- A retrospective analysis of 197 patients with cardiogenic shock and elevated bilirubin levels ( > 102 µmol/L) who underwent MARS treatment.
- Assessment of clinical outcomes, laboratory parameters, and risk factors for mortality.
Main Results:
- The median MARS treatment duration was 87 hours. High rates of complications (48-75%) including infections and organ failures were observed during treatment.
- In-hospital mortality was 66%. While bilirubin levels decreased in survivors, they did not in non-survivors during MARS.
- The Sepsis-related Organ Failure Assessment (SOFA) score at baseline was the sole independent predictor of in-hospital mortality.
Conclusions:
- In-hospital mortality remains high for patients with cardiogenic shock and liver failure, despite MARS treatment.
- Further research is needed to determine if MARS can significantly improve survival rates in this critically ill patient group.
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