Cost-effectiveness of the artificial liver support system MARS in patients with acute-on-chronic liver failure

@article{Hessel2010CosteffectivenessOT,
  title={Cost-effectiveness of the artificial liver support system MARS in patients with acute-on-chronic liver failure},
  author={Franziska Hessel and Peter Bramlage and J{\"u}rgen Wasem and Steffen R. Mitzner},
  journal={European Journal of Gastroenterology \& Hepatology},
  year={2010},
  volume={22},
  pages={213-220}
}
Background For patients with an acute exacerbation of chronic liver failure (ACLF), the molecular adsorbent recirculating system (MARS) can result in a prolongation of life, but data on costs and cost-effectiveness are lacking. Methods A health economic evaluation of a prospective controlled cohort trial in patients with ACLF not eligible for liver transplantation with 3 years follow-up and consecutive modelling of long-term costs, outcomes and cost-effectiveness was conducted. Costs were… 
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TLDR
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TLDR
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TLDR
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TLDR
Although high initial treatment costs for MARS occur the significantly better survival seen in this study led to reasonable costs per live year gained, and further randomized controlled trials investigating the medical efficacy and the cost-effectiveness are recommended.
First clinical experience with Molecular Adsorbent Recirculating System (MARS) in six patients with severe acute on chronic liver failure.
TLDR
A case series shows that MARS treatment in general can be safely performed in patients with severe liver disease, however, in Patients with an activated clotting system severe bleeding complication can be triggered and MARs treatment should be used very cautiously in these situations.
Economic evaluation of MARS--preliminary results on survival and quality of life.
TLDR
First preliminary results suggest that 1 year after therapy MARS seems to have a positive effect concerning survival rate, survival time and QALYs gained.
Economic evaluation and 1‐year survival analysis of MARS in patients with alcoholic liver disease
TLDR
1‐year results suggest an acceptable cost‐effectiveness of MARS, and prolonging the time horizon and including indirect costs, which will be done in future research, would probably improve cost‐Effectiveness.
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TLDR
The most promising results, namely the highest number of livers to recovery were observed among acute patients with liver failure due to a toxic etiology, however, it did not discover much benefit of MARS for patients with AcOCh without liver transplantation.
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TLDR
The data suggest an improved survival accompanied by significant improvements of hepatic encephalopathy, mean arterial pressure, serum bilirubin level, creatinine, urea, albumin, INR, ammonia and MELD score.
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TLDR
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TLDR
Molecular adsorbent recirculating system (MARS) treatment had no significant survival benefit on patients with liver failure when compared with standard medical therapy, and well‐conducted randomized trials are strongly recommended.
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TLDR
Although MARS improved laboratory parameters of hepatic detoxification and renal function in patients with acutely decompensated ALD, the patients' mortality remained unsatisfactorily high and the experience does not support the indiscriminative use of MARS in acutely decompensation of chronically stable alcoholic liver disease without further controlled studies.
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