Molecular Adsorbent Recirculating System Effectively Replaces Hepatic Function in Severe Acute Liver Failure

Area of Science:

• Hepatology
• Critical Care Medicine
• Transplantation Surgery

Background:

• Severe acute liver failure (ALF) presents significant physiological challenges, often necessitating liver transplantation.
• Molecular Adsorbents Recirculating System (MARS) provides temporary hepatic support, bridging patients to transplantation or recovery.

Purpose of the Study:

• To evaluate the efficacy of MARS therapy as a temporary hepatic replacement in patients with severe ALF.
• To analyze patient survival rates and liver function recovery following MARS treatment.

Main Methods:

• MARS therapy was administered to 27 patients with severe ALF, categorized by etiology: severe liver trauma (SLT), bridge to transplantation (BTT), and definitive therapy (DT) for toxic ingestion/idiopathic failure.
• Patient demographics, ALF etiology, and laboratory values were recorded.
• Survival rates (with or without transplant/recovery) were the primary endpoints.

Main Results:

• MARS therapy demonstrated significant improvements in liver function, coagulation, encephalopathy, and creatinine levels.
• In SLT patients (n=5), 60% survived with full liver and renal recovery.
• For BTT patients (n=13), 78% survival at 1 year post-transplant (9 transplanted).
• For DT patients (n=9), 67% survived with liver recovery.

Conclusions:

• MARS therapy effectively supports patients with ALF by temporarily replacing hepatic function.
• Sustained MARS support can facilitate spontaneous liver recovery, which was observed to be common.