Fulminant hepatic failure bridged to liver transplantation with a molecular adsorbent recirculating system: A single-center experience

Cataldo Doria, Lucio Mandalà, Victor L. Scott, Salvatore Gruttadauria, Ignazio R. Marino

Research output: Contribution to journalArticlepeer-review

Abstract

We herein describe the clinical course of a consecutive series of fulminant hepatic failure patients treated with a molecular adsorbent recirculating system (MARS), a cell-free albumin dialysis technique. From November 2000 to September 2002, seven adult patients ages 22-61 (median, 41), one male (14.2%) and six females (85.7%), affected by fulminant hepatic failure underwent seven courses (one to five sessions each, 6 hr in duration) of extracorporeal support using the MARS technique. Pre- and posttreatment blood glucose, liver function tests, ammonia, arterial lactate, electrolytes, hemodynamic parameters, arterial blood gases, liver histology, Glasgow Coma Scale, and coagulation studies were reviewed. No adverse side effects such as generalized bleeding on noncardiogenic pulmonary edema, often seen during MARS treatment, occurred in the patients included in this study. Six patients (85.7%) are currently alive and well, and one (14.2%) died. Four patients (57%) were successfully bridged (two patients in 1 day and two other patients in 4 days) to liver transplantation, while two (5%) recovered fully without transplantation. All the measured variables stabilized after commencement of the MARS. No differences were noted between the pre- and the post-MARS histology. We conclude that the MARS is a safe, temporary life support mechanism for patients awaiting liver transplantation or recovering from fulminant hepatic failure.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalDigestive Diseases and Sciences
Volume51
Issue number1
DOIs
Publication statusPublished - Jan 2006

Keywords

  • Albumin
  • Dialysis
  • Extracorporeal liver assist device
  • Fulminant hepatitis

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Fulminant hepatic failure bridged to liver transplantation with a molecular adsorbent recirculating system: A single-center experience'. Together they form a unique fingerprint.

Cite this