Application of MARS artificial liver support as bridging therapy before split liver retransplantation in a 15-month-old child.

Hommann M, Kasakow LB, Geoghegan J, Kornberg A, Schotte U, Fuchs D, Hermann J, Zintl F, Scheele J.

Pediatr Transplant 2002 Sep;6(4):340-3

Klinik fur Allgemeine und Viszerale Chirurgie, Friedrich-Schiller-Universitat Jena, Deutschland, Klinik fur Padiatrie, Friedrich-Schiller-Universitat Jena, Deutschland, The Liver Unit, St Vincent's Hospital, Dublin, Ireland.

Molecular Adsorbent Recirculating System (MARS) is a blood-filtering system designed to provide biological artificial liver support. We describe its use in a small child to illustrate its effectiveness and practicality in this age group. A 15-month-old male underwent split liver transplantation for acute liver failure following bone marrow transplantation. After development of graft dysfunction we instituted MARS-dialysis. MARS therapy led to a dramatic fall in serum bilirubin and transaminases. Liver synthetic function was not affected. This was accompanied by a stabilization of the patients clinical condition until repeat split liver transplantation was performed 2 weeks after the first graft. MARS-dialysis is practical in the small child. In this case, it did not provide definitive treatment but was an excellent bridging therapy before retransplantation.