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Management of Traumatic Liver Failure Using Molecular Adsorbent Recirculating System (MARS) Treatment.

Theresa A Johnson¹, Rachel L Warner¹, Marie L Crandall²

¹Department of Surgery, University of Florida Health, Jacksonville, FL, USA.

The American Surgeon

|July 27, 2025

Summary

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This case study shows Molecular Adsorbent Recirculating System (MARS) successfully treated acute liver failure from severe penetrating hepatic trauma. MARS improved patient outcomes and hepatic function, offering a potential resuscitative strategy.

Area of Science:

Trauma Surgery
Hepatology
Critical Care Medicine

Background:

Penetrating liver injuries pose significant risks of liver failure, morbidity, and mortality.
Acute liver failure following hepatic trauma presents complex management challenges.

Purpose of the Study:

To present a complex case of penetrating hepatic trauma with acute liver failure.
To evaluate the efficacy of Molecular Adsorbent Recirculating System (MARS) in managing such cases.

Main Methods:

A 28-year-old male with multiple gunshot wounds underwent surgical exploration for a destructive transhepatic trajectory.
Postoperatively, the patient received MARS therapy for eight-hour sessions over three consecutive days.

Main Results:

Keywords:

critical care liver trauma trauma acute care

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The patient demonstrated improved mental status and was weaned off vasopressors within the first day of MARS treatment.
Significant improvements were observed in hepatic function markers, including alpha fetoprotein, ammonia levels, international normalized ratio (INR), and total bilirubin.

Conclusions:

Molecular Adsorbent Recirculating System (MARS) can be a valuable component of the resuscitative strategy for patients with severe penetrating hepatic injuries.
This case highlights the successful application of MARS in managing acute liver failure secondary to complex hepatic trauma.