MARS treatment in posthepatectomy liver failure

@article{vandeKerkhove2003MARSTI,
  title={MARS treatment in posthepatectomy liver failure},
  author={Maarten-Paul van de Kerkhove and Koert Pieter de Jong and Arjen M. Rijken and Anne-Corn{\'e}lie J M de Pont and Thomas Matthijs van Gulik},
  journal={Liver International},
  year={2003},
  volume={23}
}
Abstract Posthepatectomy liver failure (PHLF) is a dramatic complication following extensive liver resection or liver resection in a compromised liver, leading to death in 80% of cases. Molecular Adsorbent Recirculating System (MARS) is able to extract water and protein bound toxins out of the blood in liver failure patients. This paper describes the initial experience in the Netherlands using the MARS liver assist device in five patients with PHLF. In all patients, improvement of biochemical… 
Posthepatectomy Liver Failure
TLDR
Adequate preoperative risk assessment and an optimal postoperative treatment are essential for PHLF prevention and prevention and treatment is discussed.
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TLDR
Post hepatectomy liver failure comprises of a conundrum of symptoms and signs following major hepatic resections and Orthotopic liver transplantation (OLT) is the last resort in most cases not responding to other measures.
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TLDR
MARS therapy can be an effective treatment of postoperative liver insufficiency in the surgical hepatobiliary unit and important prognostic factors for hepatic recovery and survival were indocyanin green plasma disappearance rates and an increase in clotting factor V levels after each MARS treatment.
Systematic review of MARS treatment in post-hepatectomy liver failure.
TLDR
Early MARS treatment is safe and feasible in patients with PHLF and currently cannot be recommended as standard of care in these patients, but further prospective studies are warranted.
The molecular adsorbent recirculating system in posthepatectomy liver failure: Results from a prospective phase I study
TLDR
The use of MARS in PHLF is feasible and safe and improves liver function in patients with PHLf, and the 60‐ and 90‐day mortality rates were unexpectedly low compared to a historical control group.
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TLDR
Improved pre-operative planning and the early recognition and treatment of PHLF will improve patient care, morbidity and ultimately the mortality from this complex postoperative complication.
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TLDR
This review aims to discuss the controversies, potential benefits, practicalities, and disadvantages of using MARS in clinical practice.
Pathophysiology and Management of Post Resection Liver Failure
TLDR
To avoid the presence of PRLF ongoing parenchymal damage after the liver resection, ischemia reperfusion injury should be minimalized, infection and sepsis should be treated immediately, and small for size syndrome should be avoided.
Defining Post Hepatectomy Liver Insufficiency: Where do We stand?
TLDR
Given its resistance to treatment and the high postoperative mortality associated with PHLF, great effort has been put in to both accurately identify patients at high risk and to develop strategies that can help prevent its occurrence.
MARS in the Treatment of Liver Failure: Controversies and Evidence
  • A. Chiu, S. Fan
  • Medicine
    The International journal of artificial organs
  • 2006
TLDR
Molecular Adsorbent Recirculation System is a form of extracorporeal detoxification system used as an artificial liver support system and in general a safe procedure, but there are still potential complications that need to be cautioned, along with various operative issues that are worth attention.
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