Removal of Bile Acids by Two Different Extracorporeal Liver Support Systems in Acute-on-Chronic Liver Failure

@article{Stadlbauer2007RemovalOB,
  title={Removal of Bile Acids by Two Different Extracorporeal Liver Support Systems in Acute-on-Chronic Liver Failure},
  author={Vanessa Stadlbauer and Peter Krisper and Ulrich Beuers and Bernd Haditsch and Daniel Schneditz and Aleksandra Jung and Csilla Putz-Bankuti and Herwig Holzer and Michael Trauner and Rudolf E. Stauber},
  journal={ASAIO Journal},
  year={2007},
  volume={53},
  pages={187-193}
}
Acute-on-chronic liver failure (ACLF) is accompanied by marked intrahepatic cholestasis leading to accumulation of cytotoxic bile acids. Extracorporeal liver support systems efficiently remove bile acids, but their effect on bile acid composition in ACLF is unknown. The aim of the present study was to compare elimination of individual plasma bile acids by albumin dialysis (Molecular Adsorbents Recirculating System, MARS) and fractionated plasma separation (Prometheus). Eight consecutive… 
Effect of extracorporeal liver support by MARS and Prometheus on serum cytokines in acute-on-chronic liver failure
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Cytokines are cleared from plasma by both MARS and Prometheus, but neither system is able to change serum cytokine levels, probably due to a high rate of cytokine production in patients with ACLF.
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Bile acid kinetic modeling in end-stage liver support patients
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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
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TLDR
While initial small studies on MARS in advanced liver failure indicated improved survival, preliminary data of two recent randomized trials of either MARS or Prometheus versus standard medical treatment demonstrated no survival benefit in large cohorts of patients with acute-on-chronic liver failure.
Extracorporeal detoxification for hepatic failure using molecular adsorbent recirculating system: depurative efficiency and clinical results in a long-term follow-up.
TLDR
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.
Clearing of toxic substances: are there differences between the available liver support devices?
TLDR
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Extracorporeal Liver Support Devices
TLDR
This chapter reviews the application of extracorporeal support technology and the current evidence associated with each support system in the management in the acute and end-stage liver failure settings.
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TLDR
Both procedures were safe for temporary extracorporeal liver support and in clinical practice routinely assessed plasma bilirubin levels were reduced by both systems, but only MARS affected other paraclinical parameters (i.e., serum bile acids, albumin-binding capacity, and creatinine and urea levels).
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