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Molecular Adsorbent Recirculating System as a Diagnostic and Therapeutic Modality.

S B Hicks1, J H Tabibian2,3

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|January 30, 2018
PubMed
Summary

The Molecular Adsorbent Recirculating System (MARS) aided in diagnosing encephalopathy in a liver failure patient. This extracorporeal liver support served as a bridge to successful liver transplantation.

Keywords:
Bioartificial liverCirrhosisHemofiltrationHepatic encephalopathyLiver transplantationOutcomes researchPrognosis

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Area of Science:

  • Hepatology
  • Nephrology
  • Critical Care Medicine

Background:

  • High mortality persists in hepatic failure patients awaiting liver transplantation (LT).
  • Molecular Adsorbent Recirculating System (MARS) is an extracorporeal device for metabolic detoxification, often bridging patients to LT.
  • Encephalopathy in end-stage liver disease presents diagnostic challenges, especially when its etiology is uncertain.

Purpose of the Study:

  • To describe the use of MARS as a diagnostic tool for encephalopathy of uncertain etiology in a patient with end-stage liver disease.
  • To propose extracorporeal liver support as a diagnostic and potentially therapeutic measure for cryptogenic encephalopathy.

Main Methods:

  • A case report of a 41-year-old male with decompensated alcoholic cirrhosis and worsening encephalopathy.
  • Implementation of MARS for diagnostic purposes in a patient with end-stage liver disease and encephalopathy of uncertain cause.
  • Monitoring psychomotor response to MARS therapy prior to LT.

Main Results:

  • The patient exhibited prompt psychomotor improvement following MARS implementation.
  • The patient successfully underwent LT 19 days after MARS initiation with an excellent clinical outcome.
  • MARS facilitated a diagnosis and improved the patient's condition, enabling successful transplantation.

Conclusions:

  • MARS can serve as a valuable diagnostic intervention for encephalopathy of uncertain etiology in patients with advanced liver disease.
  • Extracorporeal liver support, like MARS, may be beneficial not only as a bridge to LT but also as a diagnostic and therapeutic tool.
  • This approach can improve outcomes for patients with end-stage liver disease and cryptogenic encephalopathy.