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[Molecular adsorption in liver failure] |
[Article in Italian]
Ital Nefrol. 2005 Jan-Feb;22 Suppl 31:S156-60
Marangoni R.
U.O. di Epatologia, Ospedale S. Giuseppe, Milano - Italy. franca.marangoni@unimi.it
The
molecular adsorbent recirculating system (MARS) method removes from the
blood catabolites either free in the plasma water such as uremic toxins
and ammonia, taking advantage of dialysis or free albumin bound ones,
like hepatic toxins, transferring them from the albumin in the blood to
the albumin circulating in a closed loop where toxins are removed by
adsorbtion on resins (charcoal and ion exchange resin).
. The efficacy of
the method in removing the hepatic toxins either in the acute or in the
acute on chronic liver failure is demonstrated in numerous studies.
Based on these findings, 10 patients affected by acute on chronic liver
failure were treated. The results demonstrated that the method,
powerfully removing ammonia, bilirubin and bile acids (taken as method
efficacy markers), reduced the blood concentrations of these molecules
remarkably; allowing the elimination of the refractory pruritus (due to
the lowering of plasma bile acid levels), an almost constant symptom in
chronic liver diseases, especially with cholestasis, and improves other
parameters (cholinesterase, alkaline phosphatase and prothrombin
activity). These results agree with those reported in the literature
concerning the efficacy of MARS in the replacement of the liver
detoxifying function. |
