Successful use of Molecular Absorbent Regenerating System (MARS) dialysis for the treatment of fulminant hepatic failure in children accidentally poisoned by toxic mushroom ingestion

@article{Covic2003SuccessfulUO,
  title={Successful use of Molecular Absorbent Regenerating System (MARS) dialysis for the treatment of fulminant hepatic failure in children accidentally poisoned by toxic mushroom ingestion},
  author={Adrian Covic and David J. A. Goldsmith and P. Gusbeth-tatomir and Carmen Volovăţ and Alexandru Grigore Dimitriu and F Cristogel and Aurel Bizo},
  journal={Liver International},
  year={2003},
  volume={23}
}
Background: Acute liver failure (ALF) as a result of mushroom poisoning is associated with a high mortality (particularly in children), despite optimal medical therapy (OMT), including charcoal haemoperfusion and haemodiafiltration. MARS is a new, cell‐free, extracorporeal liver assistance method utilizing an albumin dialysate for the removal of albumin‐bound toxins. 
Molecular adsorbent recirculating system ( MARS ) dialysis for fulminant hepatic failure due to paracetamol overdose in children
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This case suggests that albumin dialysis may be feasible treatment option in acute liver failure due to paracetamol overdose, and treats a 4-year boy successfully with two sessions of MARS dialysis for fulminant liver failure and grade III hepatic encephalopathy.
Utilisation de la dialyse MARS en toxicologie MARS albumin dialysis in toxicology
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In clinical practice, MARS technique should be used in experienced centers for severe liver failure, particularly those from toxic origin, and more rarely for life-threatening poisonings with albumin-bound drugs, particularly when cardiovascular failure occurs.
MARS albumin dialysis in toxicology
TLDR
In clinical practice, MARS technique should be used in experienced centers for severe liver failure, particularly those from toxic origin, and more rarely for life-threatening poisonings with albumin-bound drugs, particularly when cardiovascular failure occurs.
Acute liver failure due to leptospirosis successfully treated with MARS (molecular adsorbent recirculating system) dialysis
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Albumin dialysis may confer a significant survival benefit on patients with leptospirosis-induced acute liver failure (ALF) and the MARS procedure with complete recovery of hepatic and renal function.
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    The International journal of artificial organs
  • 2006
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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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MARS appears to be a safe and highly effective depurative therapy in adults with Amanita phalloides-induced FLF.
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MARS is a promising therapy for ALF, allowing the patient's own liver to recover or allowing enough time to find a liver graft, but did not observe much benefit in patients with severe acute‐on‐chronic liver failure (AcoChr) who did not undergo liver transplantation.
Use of the molecular adsorbent recirculating system (MARS™) for the management of acute poisoning with or without liver failure
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Despite the lack of large multicentre randomized trials on the use of MARS™ in patients with acute liver failure, the literature shows clinical and biological benefit from this technique, and it is potentially a promising treatment for Patients with acute poisoning from drugs that have high protein-binding capacity and are metabolized by the liver.
Liver support for fulminant hepatic failure: Is it time to use the Molecular Adsorbents Recycling System in children?*
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    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2005
TLDR
Although promising preliminary results suggest that MARS may have a significant position in the therapeutic arsenal for FHF, no sufficient data exist to justify its use in children, and the indications of this expensive technique in children with FHF are limited.
Experience with molecular adsorbent recirculating system treatment in 20 children listed for high‐urgency liver transplantation
  • W. Lexmond, C. V. van Dael, M. Kömhoff
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    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2015
TLDR
The data demonstrate the safety of MARS even in the most severely ill patients awaiting LT, but strategies that promote the more rapid and widespread availability of high‐quality donor organs remain of critical importance for improving patient survival in cases of severe acute liver failure.
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