Category: Toxicology
Keywords: Liver dialysis, MARS (PubMed Search)
Posted: 1/18/2018 by Kathy Prybys, MD
(Updated: 1/19/2018)
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Acute liver failure carries a high morbidity without liver transplantation. Liver support systems can act as “bridge” until an organ becomes available for the transplant procedure or until the liver recovers from injury. Artificial liver support systems temporally provide liver detoxification utilizing albumin as scavenger molecule to clear the toxins without providing synthetic functions of the liver (coagulation factors). One of the most widely used devices is the Molecular Adsorbent Recirculating System (MARS).This system has 3 different fluid compartments: blood circuit, albumin with charcoal and anion exchange column, and a dialysate circuit that removes protein bound and water soluble toxins with albumin.
Bottom Line
MARS therapy could be a potentially promising life saving treatment for patients with acute poisoning from drugs that have high protein-binding capacity and are metabolized by the liver, especially when concomitment liver failure. Consider consultation and transfer of patients to liver center.
The Molecular Adsorbent Recirculating System (MARS®) in the Intensive Care Unit: A Rescue Therapy for Patients with Hepatic Failure. F Saliba, Critical Care 10.1 (2006): 118.
