Albumin dialysis using the molecular adsorbent recirculating system

@article{Mitzner2001AlbuminDU,
  title={Albumin dialysis using the molecular adsorbent recirculating system},
  author={Steffen R. Mitzner and Jan Stange and Sebastian Klammt and Piotr Peszynski and Reinhardt Schmidt},
  journal={Current Opinion in Nephrology and Hypertension},
  year={2001},
  volume={10},
  pages={777-783}
}
  • S. Mitzner, J. Stange, R. Schmidt
  • Published 1 November 2001
  • Medicine, Biology, Engineering
  • Current Opinion in Nephrology and Hypertension
Liver support systems based on either dialysis, filtration, and adsorption or plasmaperfusion over hepatocytes have been tested clinically with varying success. A new approach in this field is the selective removal of albumin-bound end products of metabolism. This can be achieved in a high-flux dialysis setting by the addition of human serum albumin as a molecular adsorbent to the dialysate with subsequent recirculation of the dialysate over sorbents (molecular adsorbent recirculating system… 
Significant Decrease in Dialysate Albumin Concentration during Molecular Adsorbent Recirculating System (M.A.R.S.) Therapy
  • D. Gong, D. Ji, L. Li
  • Medicine, Biology
    The International journal of artificial organs
  • 2008
TLDR
There is a significant reduction in dialysate albumin concentration during MARS therapy, and Binding of albumin to the adsorbent columns used for albumin regeneration is largely responsible for this decrease.
Molecular adsorbent recirculating system: Albumin dialysis‐based extracorporeal liver assist device
  • D. Kapoor
  • Medicine, Engineering
    Journal of gastroenterology and hepatology
  • 2002
TLDR
Large multicentric trials on the use of the molecular adsorbent recirculating system (MARS) are expected to throw light on some of the unresolved issues and help optimize the potential of this liver assist device.
Prometheus versus molecular adsorbents recirculating system: comparison of efficiency in two different liver detoxification devices.
TLDR
A significant decline in the serum level of water-soluble and protein-bound toxins was achieved with both devices, and PROM produces higher blood clearances for most toxins, which results in higher delivered treatment doses compared with a matching treatment with MARS.
Use of the molecular adsorbent recirculating system (MARS™) for the management of acute poisoning with or without liver failure
TLDR
Despite the lack of large multicentre randomized trials on the use of MARS™ in patients with acute liver failure, the literature shows clinical and biological benefit from this technique, and it is potentially a promising treatment for Patients with acute poisoning from drugs that have high protein-binding capacity and are metabolized by the liver.
Depurative capacity of molecular adsorbent recycling system (MARS): A focus on bilirubin removal
The molecular adsorbent recycling system (MARS) is now widely used in the treatment of patients with hepatic failure (HF). A great deal of interest has been directed toward its effect on clinical
Human Serum Albumin in Blood Detoxification Treatment
TLDR
Molecular modification of the albumin domains through site-directed mutagenesis for strengthening toxin binding is a feasible approach for improving the efficiency and effectiveness of blood detoxification treatment.
Detoxifying Capacity and Kinetics of Prometheus® – A New Extracorporeal System for the Treatment of Liver Failure
TLDR
The data suggest that the rate and efficacy of removal of albumin-bound toxins is related to both the strength of the albumin binding and the saturation of the adsorption columns.
Water-soluble adsorbent β-cyclodextrin-grafted polyethyleneimine for removing bilirubin from plasma.
...
...

References

SHOWING 1-10 OF 72 REFERENCES
Dialysis against a recycled albumin solution enables the removal of albumin-bound toxins.
TLDR
This work presents an alternative method that enables the dialyzability of albumin-bound toxins from plasma by the use of a high-flux dialyzer and an albumin solution circulating on the dialysate side to increase selectively the affinity for albumin, which resulted in effective removal of unconjugated bilirubin.
Molecular adsorbent recycling system (MARS): clinical results of a new membrane-based blood purification system for bioartificial liver support.
TLDR
A new membrane separation system that is nearly impermeable to proteins but enables the exchange of water soluble and protein bound toxins by a special membrane and a recycled protein containing dialysate is described.
Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure.
TLDR
It is concluded that the molecular adsorbent recirculating system can contribute to the treatment of critically ill patients with liver failure and different underlying diseases.
Push‐Pull Sorbent Based Pheresis for Treatment of Acute Hepatic Failure The BioLogic‐Detoxifier/Plasma Filter System
TLDR
The mechanisms of operation of this system are explained and in vitro tests that define its chemical efficiency are presented and potential problems, tests that indicate the severity of these problems, and monitors and algorithms to detect or avoid these problems in clinical use of the system are described.
Characteristics of an Albumin Dialysate Hemodiafiltration System for the Clearance of Unconjugated Bilirubin
TLDR
The clearance of unconjugated bilirubin is greatly enhanced with the use of albumin containing dialysates when compared to traditional crystalloid hemodiafiltration, is greater at lower pH, and seems to be unaffected by temperature.
Liver support by extracorporeal blood purification: A clinical observation
  • J. Stange, S. Mitzner, U. Hopt
  • Medicine, Biology
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2000
TLDR
It is concluded that in acute excretory failure caused by a chronic liver disease, this treatment provides a therapy option to remove toxins involved in multiorgan dysfunction secondary to liver failure.
Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial
  • S. Mitzner, J. Stange, R. Schmidt
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2000
TLDR
It is concluded that the removal of albumin‐bound substances with the MARS method can contribute to the treatment of type I HRS.
Extracorporeal blood purification in the management of patients with hepatic failure.
TLDR
A review of the rationale and documented utility of a wide variety of blood purification modalities used in the management of patients with liver failure finds them to be helpful in maintaining fluid, electrolyte, and acid base balance.
Results of a phase I trial evaluating a liver support device utilizing albumin dialysis.
TLDR
This phase I study suggests that albumin dialysis as a liver support device is safe and effective in clearing hepatic toxins, with an associated decrease in the HES and ICP.
Cerebral blood flow velocity increases during a single treatment with the molecular adsorbents recirculating system in patients with acute on chronic liver failure
TLDR
Cerebral perfusion is increased and levels of ammonia and bilirubin are reduced during MARS treatment in patients with AOCLF.
...
...