Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial

@article{Mitzner2000ImprovementOH,
  title={Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial},
  author={Steffen R. Mitzner and Jan Stange and Sebastian Klammt and Teut Risler and Christiane M. Erley and Brigitte Bader and Elke D. Berger and Werner Lauchart and Piotr Peszynski and Jens Freytag and Heiko Hickstein and Jan Loock and Johannes‐Mathias L{\"o}hr and Stefan Liebe and J{\"o}rg Emmrich and Gero Korten and Reinhardt Schmidt},
  journal={Liver Transplantation},
  year={2000},
  volume={6}
}
In hepatorenal syndrome (HRS), renal insufficiency is often progressive, and the prognosis is extremely poor under standard medical therapy. The molecular adsorbent recirculating system (MARS) is a modified dialysis method using an albumin‐containing dialysate that is recirculated and perfused online through charcoal and anion‐exchanger columns. MARS enables the selective removal of albumin‐bound substances. A prospective controlled trial was performed to determine the effect of MARS treatment… 
Albumindialyse bei Patienten mit sekundärem Leberversagen nach kardiogenem Schock
TLDR
It is concluded that despite the limited number of patients included in this analysis, MARS can be recommended for patients with acute, hypoxic liver failure as it can prolong survival.
Outcome of patients treated with molecular adsorbent recirculating system albumin dialysis: A national multicenter study
TLDR
It is suggested that MARS should be mainly used as a bridge to liver transplantation, and survival was correlated with being listed for most etiologies and with the intensity of treatment in ALF.
Improvement of multiple organ functions in hepatorenal syndrome during albumin dialysis with the molecular adsorbent recirculating system.
  • S. Mitzner, S. Klammt, R. Schmidt
  • Medicine
    Therapeutic apheresis : official journal of the International Society for Apheresis and the Japanese Society for Apheresis
  • 2001
TLDR
It is concluded that MARS can improve multiple organ functions in patients with HRS and one man underwent successful liver transplantation 18 months after the treatment.
Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute‐on‐chronic liver failure: The RELIEF trial
TLDR
At scheduled doses, a beneficial effect on survival of MARS therapy in patients with ACLF could not be demonstrated, however, MARS has an acceptable safety profile, has significant dialysis effect, and nonsignificantly improves severe HE.
Albumin dialysis in cirrhosis with superimposed acute liver injury: possible impact of albumin dialysis on hospitalization costs
TLDR
It appears that the benefits of MARS therapy are enough to justify the cost of treatment and safe hospital costs, at least in the described population, however, further studies are needed to confirm these results.
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.
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.
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