Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus

Cataldo Doria, Lucio Mandalá, Jan Smith, Claudio H. Vitale, Augusto Lauro, Salvatore Gruttadauria, Ignazio R. Marino, Carlo Scotti Foglieni, Mario Magnone, Victor L. Scott

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Intractable pruritus is more common in cholestatic liver diseases and may be the presenting symptom and/or major complaint of hepatitis C and/or hepatitic C virus-related cirrhosis. From September 2000 to May 2002, three patients affected by intractable pruritus secondary to hepatitis C cirrhosis that failed medical treatment were treated with a molecular adsorbent recirculating system (MARS). MARS is an artificial liver support system that aims to clear the blood of metabolic waste products normally metabolized by the liver. Each patient underwent seven MARS sessions. Liver function tests, the 36-Item Short Form quality-of-life test, visual analog scale for itching, and bile acid measurement in the serum, albumin circuit and ultrafiltrate were performed before and after each MARS session. Moreover, at hospital admission, each patient underwent a psychological workup and abdominal imaging study. Subjective improvement in pruritus and quality of life, along with a decrease in serum bile acid concentration, was observed in every patient; no patient underwent retreatment and/or liver transplantation up to a 9-month follow-up. One patient died 201 days after MARS treatment. Although we observed a decreased level of serum bile acids, one cannot conclude that this was the mechanism of action for the reduction in pruritus intensity in patients in our series. Different toxins and/or a placebo effect might have had a role in this setting.

Original languageEnglish
Pages (from-to)437-443
Number of pages7
JournalLiver Transplantation
Volume9
Issue number4
DOIs
Publication statusPublished - Apr 1 2003

Fingerprint

Pruritus
Hepacivirus
Bile Acids and Salts
Hepatitis C
Fibrosis
Quality of Life
Artificial Liver
Waste Products
Placebo Effect
Retreatment
Patient Admission
Liver Function Tests
Serum
Visual Analog Scale
Serum Albumin
Liver Transplantation
Liver Diseases
Psychology
Viruses
Liver

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus. / Doria, Cataldo; Mandalá, Lucio; Smith, Jan; Vitale, Claudio H.; Lauro, Augusto; Gruttadauria, Salvatore; Marino, Ignazio R.; Foglieni, Carlo Scotti; Magnone, Mario; Scott, Victor L.

In: Liver Transplantation, Vol. 9, No. 4, 01.04.2003, p. 437-443.

Research output: Contribution to journalArticle

Doria, C, Mandalá, L, Smith, J, Vitale, CH, Lauro, A, Gruttadauria, S, Marino, IR, Foglieni, CS, Magnone, M & Scott, VL 2003, 'Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus', Liver Transplantation, vol. 9, no. 4, pp. 437-443. https://doi.org/10.1053/jlts.2003.50055
Doria, Cataldo ; Mandalá, Lucio ; Smith, Jan ; Vitale, Claudio H. ; Lauro, Augusto ; Gruttadauria, Salvatore ; Marino, Ignazio R. ; Foglieni, Carlo Scotti ; Magnone, Mario ; Scott, Victor L. / Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus. In: Liver Transplantation. 2003 ; Vol. 9, No. 4. pp. 437-443.
@article{91518da94fe84bf6acd73facb264a802,
title = "Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus",
abstract = "Intractable pruritus is more common in cholestatic liver diseases and may be the presenting symptom and/or major complaint of hepatitis C and/or hepatitic C virus-related cirrhosis. From September 2000 to May 2002, three patients affected by intractable pruritus secondary to hepatitis C cirrhosis that failed medical treatment were treated with a molecular adsorbent recirculating system (MARS). MARS is an artificial liver support system that aims to clear the blood of metabolic waste products normally metabolized by the liver. Each patient underwent seven MARS sessions. Liver function tests, the 36-Item Short Form quality-of-life test, visual analog scale for itching, and bile acid measurement in the serum, albumin circuit and ultrafiltrate were performed before and after each MARS session. Moreover, at hospital admission, each patient underwent a psychological workup and abdominal imaging study. Subjective improvement in pruritus and quality of life, along with a decrease in serum bile acid concentration, was observed in every patient; no patient underwent retreatment and/or liver transplantation up to a 9-month follow-up. One patient died 201 days after MARS treatment. Although we observed a decreased level of serum bile acids, one cannot conclude that this was the mechanism of action for the reduction in pruritus intensity in patients in our series. Different toxins and/or a placebo effect might have had a role in this setting.",
author = "Cataldo Doria and Lucio Mandal{\'a} and Jan Smith and Vitale, {Claudio H.} and Augusto Lauro and Salvatore Gruttadauria and Marino, {Ignazio R.} and Foglieni, {Carlo Scotti} and Mario Magnone and Scott, {Victor L.}",
year = "2003",
month = "4",
day = "1",
doi = "10.1053/jlts.2003.50055",
language = "English",
volume = "9",
pages = "437--443",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "4",

}

TY - JOUR

T1 - Effect of molecular adsorbent recirculating system in hepatitis C virus-related intractable pruritus

AU - Doria, Cataldo

AU - Mandalá, Lucio

AU - Smith, Jan

AU - Vitale, Claudio H.

AU - Lauro, Augusto

AU - Gruttadauria, Salvatore

AU - Marino, Ignazio R.

AU - Foglieni, Carlo Scotti

AU - Magnone, Mario

AU - Scott, Victor L.

PY - 2003/4/1

Y1 - 2003/4/1

N2 - Intractable pruritus is more common in cholestatic liver diseases and may be the presenting symptom and/or major complaint of hepatitis C and/or hepatitic C virus-related cirrhosis. From September 2000 to May 2002, three patients affected by intractable pruritus secondary to hepatitis C cirrhosis that failed medical treatment were treated with a molecular adsorbent recirculating system (MARS). MARS is an artificial liver support system that aims to clear the blood of metabolic waste products normally metabolized by the liver. Each patient underwent seven MARS sessions. Liver function tests, the 36-Item Short Form quality-of-life test, visual analog scale for itching, and bile acid measurement in the serum, albumin circuit and ultrafiltrate were performed before and after each MARS session. Moreover, at hospital admission, each patient underwent a psychological workup and abdominal imaging study. Subjective improvement in pruritus and quality of life, along with a decrease in serum bile acid concentration, was observed in every patient; no patient underwent retreatment and/or liver transplantation up to a 9-month follow-up. One patient died 201 days after MARS treatment. Although we observed a decreased level of serum bile acids, one cannot conclude that this was the mechanism of action for the reduction in pruritus intensity in patients in our series. Different toxins and/or a placebo effect might have had a role in this setting.

AB - Intractable pruritus is more common in cholestatic liver diseases and may be the presenting symptom and/or major complaint of hepatitis C and/or hepatitic C virus-related cirrhosis. From September 2000 to May 2002, three patients affected by intractable pruritus secondary to hepatitis C cirrhosis that failed medical treatment were treated with a molecular adsorbent recirculating system (MARS). MARS is an artificial liver support system that aims to clear the blood of metabolic waste products normally metabolized by the liver. Each patient underwent seven MARS sessions. Liver function tests, the 36-Item Short Form quality-of-life test, visual analog scale for itching, and bile acid measurement in the serum, albumin circuit and ultrafiltrate were performed before and after each MARS session. Moreover, at hospital admission, each patient underwent a psychological workup and abdominal imaging study. Subjective improvement in pruritus and quality of life, along with a decrease in serum bile acid concentration, was observed in every patient; no patient underwent retreatment and/or liver transplantation up to a 9-month follow-up. One patient died 201 days after MARS treatment. Although we observed a decreased level of serum bile acids, one cannot conclude that this was the mechanism of action for the reduction in pruritus intensity in patients in our series. Different toxins and/or a placebo effect might have had a role in this setting.

UR - http://www.scopus.com/inward/record.url?scp=0344059208&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344059208&partnerID=8YFLogxK

U2 - 10.1053/jlts.2003.50055

DO - 10.1053/jlts.2003.50055

M3 - Article

C2 - 12682899

AN - SCOPUS:0344059208

VL - 9

SP - 437

EP - 443

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 4

ER -