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

@article{Klammt2002ExtracorporealLS,
  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},
  journal={Liver},
  year={2002},
  volume={22 Suppl 2},
  pages={
          30-4
        }
}
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… 
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References

SHOWING 1-9 OF 9 REFERENCES
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.
TLDR
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.
TLDR
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.
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.
Role of the molecular adsorbent recycling system (MARS) in the treatment of patients with acute exacerbation of chronic liver failure
TLDR
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.
TLDR
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.