20 May 2003 : Original article
Albumin dialysis (MARS)as a new supportive treatment in patients with hepatic encephalopathy
J. Rubik, S. Prokurat, J. Pawłowska, R. Grenda, P. Kaliciński, M. Migdał, A. KamińskiMed Sci Monit 2003; 9(2): 77-81 :: ID: 15327
Abstract
Hepatic encephalopathy (HE)may occur in patients with acute and decompensated chronic liver failure.One of the pathogenetic mechanisms is accumulation of ‘liver ’toxins such as ammonia in astrocytes causing brain oedema.In cases of acute liver failure deterioration of patient ’s condition to coma may be rapid and outcome poor.Multiple attempts have been made to reduce mortality of patients with HE.Urgent liver transplantation is considered as treatment of choice in most patients.Many therapies have been used to remove ‘liver ’toxins from circulation:dialysis, hemoperfusion, plasmapheresis, extracorporeal liver perfusion and others.None of them remained in routine clinical practice.Recently a new cell-free method designed for the selective removal of albumin-bound substances normally cleared by the liver (MARS –Molecular Adsorbent Recirculating System) is available. We have been using this method in Children ’s Memorial Health Institute since July 2001 to support vital functions in some patients listed for liver transplantation.Till now we have performed 11 sessions in 7 patients with acute liver failure and hepatic encephalopathy.Four patients survived (one recovered without liver transplantation and three were transplanted) and three patients died (two before organ for transplantation was available and one during surgical procedure).We have obtained decrease of serum toxins concentration (ammonia, bilirubine, creatinine and others) and clinical improvement. In our opinion albumin dialysis MARS is promising new method of detoxification in critically ill patients with liver dysfunction.
Keywords: hepatic encephalopathy, albumin dialysis, Mars
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
26 Feb 2024 : Clinical Research
Predictive Value of Combined HbA1c and Neutrophil-to-Lymphocyte Ratio for Diabetic Peripheral Neuropathy in...Med Sci Monit In Press; DOI: 10.12659/MSM.942509
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952