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Wednesday, 15 April 2009 |
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Extracorporeal albumin dialysis.
Hepatol Res. 2008 Nov;38
Rifai K.
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Patients
with liver failure still present a high mortality. It can only be
significantly improved by the rare resource of liver transplantation.
Extracorporeal liver support devices have been developed to temporarily
support liver detoxification. Artificial devices without hepatocytes
("liver dialysis" or "albumin dialysis") are already widely used in
Europe. The two best-known systems, MARS and Prometheus, use a
different technical approach to remove water-soluble as well as
albumin-bound toxins from the blood. In MARS, toxins diffuse along a
concentration gradient through an albumin-impermeable membrane into a
secondary circuit that is pre-filled with an albumin solution. The
albumin is continuously "recycled" inside the secondary circuit by
different adsorber and low flux dialysis.
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Wednesday, 15 April 2009 |
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Molecular adsorbent recirculating system (Mars) in
patients with primary nonfunction and other causes of graft dysfunction
after liver transplantation in the era of extended criteria donor
organs.
Transplant Proc. 2009 Jan-Feb;41(1):253-8.
Gaspari R, Cavaliere F, Sollazzi L, Perilli V, Melchionda I, Agnes S, Gasbarrini A, Avolio AW.
Department of Anaesthesia and Intensive Care, Catholic University of Rome, Rome, Italy.
Liver
dysfunction is an important cause of morbidity and mortality after
orthotopic liver transplantation (OLT). The Molecular Adsorbent
Recirculating System (MARS) is an albumin-based dialysis system
designed to enhance the excretory function of a failing liver. MARS has
been successfully used in patients affected by advanced liver disease
and presenting with severe cholestasis. The aim of this study was to
evaluate the safety and clinical efficacy of MARS in patients with
liver dysfunction after OLT. Seven patients (primary nonfunction, 2
patients; graft dysfunction, 5 patients) fulfilled the inclusion
criteria of serum bilirubin level >15 mg/dL and least 1 of the
following clinical signs: hepatic encephalopathy (HE) > or = grade
II, hepatorenal syndrome (HRS), and intractable pruritus.
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