Extracorporeal liver support by recirculating albumin dialysis: analysing the effect of the first clinically used generation of the MARSystem.

  title={Extracorporeal liver support by recirculating albumin dialysis: analysing the effect of the first clinically used generation of the MARSystem.},
  author={Sebastian Klammt and Jan Stange and Steffen R. Mitzner and Piotr Peszynski and Eva Peters and S. Liebe},
  volume={22 Suppl 2},
UNLABELLED Albumin dialysis with the MARSystem is used in many hospitals to support excretory hepatic function in acute or acute on chronic liver failure. Potential pathogenic albumin bound substances accumulated in excretory liver insufficiency can be removed from patients blood by dialysis against albumin solution. A specific membrane enables the selective transport of albumin bound metabolites to the albumin containing dialysate compartment, where the loaded transport albumin is cleared and… 
The effect of molecular adsorbent recirculating system on pathophysiological parameters in patients with acute liver failure
MARS therapy was well tolerated, with significant increases in vascular tone during the first session, but this increase was not sustained over the duration of the study with a return to baseline values by the end of the second session.
Molecular Adsorbent Recirculating System (MARS) Application in Liver Failure: Clinical and Hemodepurative Results in 22 Patients
MARS treatment led in all patients to an improvement of clinical, hemodynamic and neurological conditions, with significant reduction in the hepatic toxins blood level.
Extracorporeal detoxification for hepatic failure using molecular adsorbent recirculating system: depurative efficiency and clinical results in a long-term follow-up.
In conclusion, MARS was clinically well tolerated by all patients and significantly reduced hepatic toxins and growth factors, but patients' clinical characteristics on starting MARS therapy were the main factors predicting survival.
A modeling study of bilirubin kinetics during Molecular Adsorbent Recirculating System sessions.
The results suggest that the model may be used a priori to achieve a satisfactory prediction of the overall bilirubin removal, as well as a posteriori for the estimation of device parameters.
Extracorporeal Mass Exchange Technology Platform for Temporary Liver Support: A Clinical Feasibility Study on a Device and the Cell Source Primary Human Liver Cells
  • J. Gerlach
  • Medicine, Biology
    Surgical Case Reports
  • 2019
The mass exchanger technology platform, the Core Module used with primary human liver cells as Metabolic Module, proved to be clinically feasible and safe and further clinical studies are required to prove the efficacy of such therapies.
No Sustained Impact of Intermittent Extracorporeal Liver Support on Thrombocyte Time Course in a Randomized Controlled Albumin Dialysis Trial
  • S. Klammt, S. Mitzner, E. Reisinger, J. Stange
  • Medicine, Biology
    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
  • 2014
Reduction of platelets during intermittent extracorporeal liver support was less pronounced within a 24‐h period as before and after a single treatment and was comparable to variations in the control group without extacorporeal therapy.
Liver support for fulminant hepatic failure: Is it time to use the Molecular Adsorbents Recycling System in children?*
  • P. Tissières, J. Sasbón, D. Devictor
  • Medicine
    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2005
Although promising preliminary results suggest that MARS may have a significant position in the therapeutic arsenal for FHF, no sufficient data exist to justify its use in children, and the indications of this expensive technique in children with FHF are limited.
The place of adsorption and biochromatography in extracorporeal liver support systems.


The molecular adsorbents recycling system as a liver support system based on albumin dialysis: a summary of preclinical investigations, prospective, randomized, controlled clinical trial, and clinical experience from 19 centers.
In treating liver failure and cholestasis, MARS was associated with hemodynamic stabilization, improvement of hepatic and kidney function, and disappearance of pruritus, and a prospective, randomized, controlled trial of MARS treatment was able to prolong survival time significantly.
Use of sorbent columns and haemofiltration in fulminant hepatic failure.
Experiments on adsorbents to remove cytokines have shown that Amberlite XAD-7 resin can remove significant amounts of tumour necrosis factor and interleukin-6 from liver failure plasma, a major advance in liver support.
Results of a phase I trial evaluating a liver support device utilizing albumin dialysis.
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.
Role of the molecular adsorbent recycling system (MARS) in the treatment of patients with acute exacerbation of chronic liver failure
Applying MARS treatments to patients with acute exacerbation of chronic liver disease can detoxify blood, improve cerebral circulation, and reduce brain edema, as reflected by the reduction in intracranial pressure and jugular bulb oxygen saturation values in the authors' patients.
Circulatory, respiratory, cerebral, and renal derangements in acute liver failure: pathophysiology and management.
The use of N-acetylcysteine and prostacyclin, a vasodilator, have been shown to increase oxygen utilization in the microcirculation, suggesting that despite overproduction of NO in ALF, there is a short-age/ failure of utilization at a cellular level.