Improvement in Central Nervous System Functions During Treatment of Liver Failure with Albumin Dialysis MARS—A Review of Clinical, Biochemical, and Electrophysiological Data

@article{Mitzner2004ImprovementIC,
  title={Improvement in Central Nervous System Functions During Treatment of Liver Failure with Albumin Dialysis MARS—A Review of Clinical, Biochemical, and Electrophysiological Data},
  author={Steffen R. Mitzner and Jan Loock and Piotr Peszynski and Sebastian Klammt and Jolanta Majcher-Peszynska and Alexandra Gramowski and Jan Stange and Reinhardt Schmidt},
  journal={Metabolic Brain Disease},
  year={2004},
  volume={17},
  pages={463-475}
}
The Molecular Adsorbent Recirculating System (MARS) is a nonbiological liver support method based on the principles of dialysis, filtration, and adsorption. It allows the safe and efficient removal of both albumin-bound and water-soluble toxic metabolites, including ammonia, aromatic amino acids, tryptophan, and related phenolic and indolic products, as well as benzodiazepines. A well-documented effect of the treatment is the improvement of the hemodynamic situation of decompensated chronic… 
Albumin Dialysis MARS: Knowledge from 10 Years of Clinical Investigation
TLDR
Together, albumin dialysis represents a valuable therapeutic tool for the treatment of various types of liver failure and ongoing and future studies will help define the optimal patient selection and technical process parameters such as session length and frequency of treatment.
Role of artificial liver support in hepatic encephalopathy
TLDR
Clinical studies have shown that artificial liver support, especially albumin dialysis, is able to improve HE in acute and acute-on-chronic liver failure, and further studies are required to better understand the mechanism.
Aromatic amino acid metabolism during liver failure.
TLDR
Data obtained in patients undergoing liver resection or with a transjugular intrahepatic portasystemic stent shunt (TIPSS), where these veins are accessible are discussed, to discuss the role of AAA in the pathogenesis of HE.
Extracorporeal liver support-albumin dialysis with the Molecular Adsorbent Recirculating System (MARS).
Extracorporeal liver support has been a much studied topic throughout the last 50 years. Albumin dialysis as a therapeutic option for patients with acute liver failure or acute decompensation of
Artificial liver support systems in the management of complications of cirrhosis.
TLDR
Better understanding of the pathophysiology of ACLF, further development of the current systems, and their evaluation in appropriately controlled clinical studies are necessary to translate their application to improvement in outcome of patients with ACLF.
Single-Pass Albumin Dialysis in the Treatment of Children with Liver Failure
TLDR
Investigation of the efficacy and safety of single-pass albumin dialysis (SPAD) in children with liver failure found it was effective in detoxification, as measured by significant improvement of HE and clearance from surrogate laboratory parameters.
Acute-on-chronic liver failure: extracorporeal liver assist devices
TLDR
Liver support systems are safe and well tolerated when used in management of patients with ACLF and should continue in controlled clinical trials to explore their role in bridging patients to liver transplantation or recovery in well defined patient groups.
Anticoagulation minimization is safe and effective in albumin liver dialysis using the molecular adsorbent recirculating system.
TLDR
Heparin-minimized MARS did not compromise circuit function and longevity in extended intermittent MARS, and priming with heparin saline was safe.
Equipment review: The molecular adsorbents recirculating system (MARS®)
TLDR
Preliminary experience with MARS therapy, instituted late in the clinical course of five patients with severely impaired liver function, indicates some clinical efficacy, but the overall survival rate remained poor and the overall impact on outcome remained poor.
Molecular adsorbent recirculating system dialysis in patients with acute liver failure who are assessed for liver transplantation
TLDR
A statistically significant improvement of liver function was observed after MARS therapy, andTransplant-free recovery was more frequent than expected and the apparent benefit of MARS dialysis to treat acute liver failure needs to be confirmed by a controlled study.
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