ArticlePloS one2017
Molecular adsorbent recirculating system (MARS) in acute liver injury and graft dysfunction: Results from a case-control study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 42 citations in OpenAlex.
- Plasma Adsorption Perfusion (BR-350) Versus Open Albumin Dialysis (OPAL) for Hyperbilirubinemia in Hepatic Failure in Cirrhotic Patients.Artificial organs · 2026Article
- Revolutionizing medicine: Exploring the breakthroughs in liver xenotransplantation.Liver research (Beijing, China) · 2025Review
- Acetaminophen Poisoning: Case Reports of Early Liver Dialysis for Hepatic Injury.Clinical case reports · 2025Article
- Sequential Use of High-Volume Plasma Exchange and Continuous Renal Replacement Therapy in Hepatitis B Virus-Related Acute Liver Failure: A Case Report.GE Portuguese journal of gastroenterology · 2023Article
- Molecular Adsorbent Recirculating System for Acute Liver Failure in a New Pediatric-Based Extracorporeal Liver Support Program.Critical care explorations · 2023Article
- Kidney Outcomes Following Utilization of Molecular Adsorbent Recirculating System.Kidney international reports · 2023Article
- Artificial liver support in patients with liver failure: a modified DELPHI consensus of international experts.Intensive care medicine · 2022Review
- Adverse events, short- and long-term outcomes of extra corporeal liver therapy in the intensive care unit: 16 years experience with MARS® in a single center.Critical care (London, England) · 2022Article
- Review
- Kinetics of Bilirubin and Ammonia Elimination during Hemadsorption Therapy in Secondary Sclerosing Cholangitis Following ECMO Therapy and Severe COVID-19.Biomedicines · 2021Article
- Successful elimination of bilirubin in critically ill patients with acute liver dysfunction using a cytokine adsorber and albumin dialysis: a pilot study.Scientific reports · 2021Observational
- Transplant Hepatectomy With Portacaval Shunt and MARS Therapy for Perioperative Catastrophe: A Series of Four Liver Transplant Cases.Transplantation direct · 2021Article
- End-stage liver failure: filling the treatment gap at the intensive care unit.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2020Review
- Extracorporeal liver support: trending epidemiology and mortality - a nationwide database analysis 2007-2015.BMC gastroenterology · 2019Article
- A review of pig liver xenotransplantation: Current problems and recent progress.Xenotransplantation · 2019Review
- Acute Fatty Liver of Pregnancy: Pathophysiology, Anesthetic Implications, and Obstetrical Management.Anesthesiology · 2019Review
- 10 tips for intensive care management of transplanted liver patients.Intensive care medicine · 2019Article
- Artificial liver support systems: what is new over the last decade?Annals of intensive care · 2018Review
- Liver xenotransplantation.Current opinion in organ transplantation · 2017Review
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated.
aimWe studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD).
methodsWe report on our experience over a 6.5-year period with 73 patients treated with SMT or with SMT and MARS (MARS group). In total, 53 patients suffered from acute liver injury in their native liver without a preexisting liver disease (SMT: n = 31, MARS: n = 22), and 20 patients showed a severe GD after LT (SMT: n = 10, MARS: n = 10).
resultsThe entire cohort was predominantly characterized by hemodynamically and respiratorily stable patients with a low hepatic encephalopathy (HE) grade and a model of end-stage liver disease (MELD) score of 20.57 (MARS) or 22.51 (SMT, p = 0.555). Within the MARS group, the median number of extracorporeal therapy sessions was four (range = 3-5 sessions). Independent of the underlying etiology, MARS improved the patients' bilirubin values in the short term compared to SMT alone. In patients with acute liver injury, this response was sustained even after the end of MARS therapy. By contrast, the majority of patients with GD and an initial response to MARS therapy experienced worsened hyperbilirubinemia. No differences in 28-day mortality were observed with respect to acute liver injury (MARS 5.3% (95% CI: 0-15.3); SMT 3.3% (95% CI: 0-9.8), p = 0.754) or GD (MARS 20.0% (95% CI: 0-44.7), SMT 11.1% (95% CI: 0-31.7), p = 0.478).
conclusionsAlthough it did not improve 28-day mortality, MARS therapy improved the short-term response in patients with acute liver injury as well as in those with GD. In cases of acute hepatic injury, the use of MARS therapy resulted in the sustained stabilization of liver function and improved liver regeneration. A short-term response to MARS may predict the future course of the disease.
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