MARS: Should I Use It?

Area of Science:

• Hepatology
• Biomedical Engineering
• Critical Care Medicine

Background:

• Severe liver failure carries a high mortality rate, with many patients succumbing due to organ shortages for transplantation.
• Liver transplantation, while effective, faces limitations due to donor scarcity and patient acuity.
• Extracorporeal liver support systems, such as the Molecular Adsorbent Recirculating System (MARS), are emerging as critical interventions.

Purpose of the Study:

• To critically evaluate the controversies, potential benefits, and practical considerations of utilizing the MARS system in clinical practice.
• To provide a comprehensive overview of MARS therapy for liver failure and related conditions.
• To discuss the disadvantages and limitations associated with MARS application.

Main Methods:

• This review synthesizes existing clinical data and literature on the application of the MARS system.
• It examines the use of MARS in acute liver failure and acute-on-chronic liver failure.
• The review also considers MARS applications in drug intoxication and severe cholestatic pruritus.

Main Results:

• MARS functions as a bridge to transplantation, supporting patients awaiting a liver allograft.
• It also serves as a bridge to recovery for patients with potential for hepatic regeneration.
• The system has demonstrated utility in managing acute liver insults and specific non-liver failure conditions.

Conclusions:

• The MARS system presents a valuable therapeutic option for select patients with severe liver dysfunction.
• Careful patient selection and understanding of MARS limitations are crucial for optimal outcomes.
• Further research is warranted to fully elucidate the long-term efficacy and cost-effectiveness of MARS therapy.