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Molecular adsorbant recirculating system

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https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#1
Bailey E Sparks, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter)...
October 7, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27851331/1696-reversal-of-calcium-channel-blocker-toxicity-with-molecular-adsorbents-recirculating-system
#2
Jennifer Eldred, Michael Evans, Bob Bridgman, Ram Subramanian
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27819764/combination-of-molecular-adsorbent-recirculating-system-and-radioiodine-for-the-treatment-of-concurrent-hyperthyroidism-and-severe-liver-dysfunction-a-retrospective-cohort-study
#3
Qing Zhang, Yanxing Guan, Tianxin Xiang, Shaozheng Liu, Qingjie Chen, Qing Zhang
OBJECTIVE: The treatment of hyperthyroidism associated severe liver dysfunction is a clinical challenge, and there haven't been an unified cognize up to now. The objective of this study was to assess the efficacy and safety of (131)I in combination with a molecular adsorbent recirculating system (MARS) for the treatment of hyperthyroidism complicated by severe liver dysfunction (LD). METHODS: A total of 116 hyperthyroidism patients with concomitant LD who received MARS treatment were studied retrospectively...
November 7, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27740530/%C3%A2-albumin-dialysis-with-mars-for-the-treatment-of-anabolic-steroid-induced-cholestasis
#4
Francia C Díaz, Esteban Sáez-González, Salvador Benlloch, Diego Álvarez-Sotomayor, Isabel Conde, Begoña Polo, María García, María Rodríguez, Martín Prieto
:  Background and aims. Steroid-related hepatotoxicity has become one of the most relevant causes of drug induced liver cholestasis. Some patients do not improve after standard medical treatment (SMT) and may therefore require other approaches, like extracorporeal liver support. MATERIAL AND METHODS: We report four cases of patients with pruritus, abnormal liver function tests and biopsy-proven anabolic steroid-induced cholestasis who were unresponsive to SMT. They underwent treatment with albumin dialysis (Molecular Adsorbent Recirculating System -MARS®-)...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27631450/-organ-replacement-therapy-extracorporeal-liver-assist-devices
#5
Barbara Sinner, Gabriele I Kirchner
Liver failure is a disease with a high mortality rate. Often liver transplantation is the sole therapeutic option. On the one hand, liver support systems probably support the liver to allow regeneration, on the other hand they are an option to bridge for transplantation. This article gives an overview on the clinically used liver assist devices (molecular adsorbent recirculating system [MARS], Prometheus system, single-pass albumin dialysis [SPAD], plasmapheresis) and discusses the applications in liver failure...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27394132/comparison-of-two-different-modes-of-molecular-adsorbent-recycling-systems-for-liver-dialysis
#6
Euan Soo, Anja Sanders, Karlheinz Heckert, Tobias Vinke, Franz Schaefer, Claus Peter Schmitt
BACKGROUND: In children acute liver failure is a rare but life-threatening condition from which two-thirds do not recover with supportive therapy. Treatment is limited by the availability of liver transplants. Molecular adsorbent recirculating system (MARS) dialysis is a bridge to transplantation that enhances the chances of survival during the waiting period for a transplant, although it cannot improve survival. Open albumin dialysis (OPAL) is a new mode of albumin dialysis developed to further improve dialysis efficiency...
November 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/26929255/liver-support-with-albumin-dialysis-reduces-hepatitis-c-virus-viremia-and-facilitates-antiviral-treatment-of-severe-hepatitis-c-virus-recurrence-after-liver-transplantation
#7
Luis Ibáñez-Samaniego, María-Vega Catalina, Diego Rincón, Oreste Lo Iacono, Ainhoa Fernández, Gerardo Clemente, Rafael Bañares, Javier Vaquero, Magdalena Salcedo
Patients with severe hepatitis C virus (HCV) recurrence after liver transplantation (LT) present an ominous prognosis, rarely achieving sustained virological response (SVR). Dialysis procedures may transiently decrease the HCV viral load, but the effect of albumin dialysis is currently unknown. Here, we evaluated the impact of albumin dialysis using the Molecular Adsorbent Recirculating System (MARS) used as a co-adjuvant antiviral treatment for severe HCV recurrence after LT. Thirteen patients (11 males, median age 48 years) with fibrosing cholestatic hepatitis or METAVIR fibrosis score ≥ F3 with severe portal hypertension underwent three consecutive MARS sessions...
April 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/26657702/the-plateau-phenomenon-of-stepwise-extracorporeal-albumin-dialysis-bispectral-index-hepatic-encephalopathy-recovery
#8
Ashraf A Dahaba
The Bispectral Index™ monitor, an electroencephalographic-derived parameter, can quantify hepatic encephalopathy cerebral function recovery and differentiate between West Haven grades 1 to 4. I report a very peculiar "plateau" phenomenon of 3 clear distinct plateaus of stepwise albumin dialysis Bispectral Index hepatic encephalopathy recovery during an 8-hour Molecular Adsorbent Recirculating System™ (MARS™) liver-assist extracorporeal detoxification, manifesting in conjunction with 3 West Haven grade recoveries...
December 15, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/26557005/inflammation-a-novel-target-of-current-therapies-for-hepatic-encephalopathy-in-liver-cirrhosis
#9
REVIEW
Ming Luo, Jian-Yang Guo, Wu-Kui Cao
Hepatic encephalopathy (HE) is a severe neuropsychiatric syndrome that most commonly occurs in decompensated liver cirrhosis and incorporates a spectrum of manifestations that ranges from mild cognitive impairment to coma. Although the etiology of HE is not completely understood, it is believed that multiple underlying mechanisms are involved in the pathogenesis of HE, and one of the main factors is thought to be ammonia; however, the ammonia hypothesis in the pathogenesis of HE is incomplete. Recently, it has been increasingly demonstrated that inflammation, including systemic inflammation, neuroinflammation and endotoxemia, acts in concert with ammonia in the pathogenesis of HE in cirrhotic patients...
November 7, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26488754/adsorption-of-selected-antibiotics-to-resins-in-extracorporeal-blood-purification
#10
Stephan Harm, Anna Gruber, Franz Gabor, Jens Hartmann
BACKGROUND/AIMS: Extracorporeal blood purification systems (EBS) use specific adsorbents for the elimination of toxins and cytokines. The aim of this study was to test different adsorbents for their ability to reduce antibiotics in parallel to extracorporeal blood purification therapy. METHODS: The in vitro adsorption experiments were carried out in human plasma with a newly established hydrophobic resin (Amberchrom CG161c) and adsorbents commercially available and approved in the clinics...
2016: Blood Purification
https://www.readbyqxmd.com/read/26311600/albumin-dialysis-for-liver-failure-a-systematic-review
#11
REVIEW
Evangelos Tsipotis, Asim Shuja, Bertrand L Jaber
Albumin dialysis is the best-studied extracorporeal nonbiologic liver support system as a bridge or destination therapy for patients with liver failure awaiting liver transplantation or recovery of liver function. We performed a systematic review to examine the efficacy and safety of 3 albumin dialysis systems (molecular adsorbent recirculating system [MARS], fractionated plasma separation, adsorption and hemodialysis [Prometheus system], and single-pass albumin dialysis) in randomized trials for supportive treatment of liver failure...
September 2015: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/26289310/extracorporeal-elimination-of-piperacillin-tazobactam-during-molecular-adsorbent-recirculating-system-therapy
#12
Heather A Personett, Scott L Larson, Erin N Frazee, Scott L Nyberg, Ziad M El-Zoghby
Use of the Molecular Adsorbent Recirculating System (MARS) as a liver support device continues to grow worldwide. Various components of the MARS circuit remove both protein-bound and water-soluble molecules. Little is known about the extent of the enhanced clearance mechanisms used in MARS therapy on drug elimination. Of particular interest to acute care practitioners is the impact of MARS on antibiotic clearance, as suboptimal concentrations of such drugs can negatively impact patient outcomes. The properties of piperacillin/tazobactam suggest that elimination may be enhanced in the setting of MARS therapy...
August 2015: Pharmacotherapy
https://www.readbyqxmd.com/read/26164219/covert-and-overt-hepatic-encephalopathy-diagnosis-and-management
#13
REVIEW
Kavish R Patidar, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is part of a spectrum of neurocognitive changes in cirrhosis. HE is divided into 2 broad categories based on severity: covert hepatic encephalopathy (CHE) and overt hepatic encephalopathy (OHE). CHE has a significant impact on a patient's quality of life, driving performance, and recently has been associated with increased hospitalizations and death. Likewise, OHE is associated with increased rates of hospitalizations and mortality, and poor quality of life. Given its significant burden on patients, care takers, and the health care system, early diagnosis and management are imperative...
November 2015: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/26006182/mixed-amlodipine-valsartan-overdose-treated-by-the-molecular-adsorbent-recirculating-system-mars%C3%A2
#14
Ludovic Gérard, Anne-Cécile Galloy, Arnaud Capron, Philippe Hantson
CASE REPORT: We describe the case of a 58-year-old woman who developed a severe distributive shock following the intentional ingestion of a large overdose of amlodipine (480 mg) combined with valsartan (3680 mg). Extreme vasoplegia remained refractory to maximal standard therapy including fluid resuscitation, intravenous calcium, vasopressors at very high doses, hyperinsulinemia-euglycemia therapy, lipid emulsion, and methylene blue administration. Besides, the patient exhibited hyperglycemia refractory to very high doses of insulin...
July 2015: Clinical Toxicology
https://www.readbyqxmd.com/read/25865318/continuous-molecular-adsorbent-recirculating-system-treatment-in-69-patients-listed-for-liver-transplantation
#15
Per Olin, John Hausken, Aksel Foss, Tom Hemming Karlsen, Espen Melum, Håkon Haugaa
OBJECTIVE: The molecular adsorbent recirculating system (MARS) is used to purify blood from albumin-bound toxins in patients with liver failure. However, the application of MARS has not demonstrated improved survival in randomized clinical trials and the clinical utility has not been finally established. In our department, the use of MARS is now restricted to the most critically ill patients with acute or acute on chronic liver failure. MATERIAL AND METHODS: Since 2005, we have treated 69 patients (30 males/39 females with median age of 49 years ranging from 1 months to 70 years) listed for liver transplantation (LT) with MARS...
2015: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/25820488/ex-vivo-resection-of-hepatic-neoplasia-and-autotransplantation-a-case-report-and-review-of-the-literature
#16
REVIEW
Meredith A Baker, Warren R Maley, Laurence Needleman, Cataldo Doria
INTRODUCTION: Ex situ liver resection is an uncommon procedure but offers an opportunity for R0 surgical resection of liver tumors that are otherwise unresectable. Liver insufficiency following extensive resections is a risk in this patient population; consequently, all measures should be taken to prevent this highly morbid complication. METHOD: We report a case of a patient with an extensive cholangiocarcinoma involving all three hepatic veins that required ex vivo resection and liver autotransplantation to achieve an R0 resection...
June 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/25438293/molecular-adsorbent-recirculating-system-and-bioartificial-devices-for-liver-failure
#17
REVIEW
Rafael Bañares, María-Vega Catalina, Javier Vaquero
Acute liver failure and acute-on-chronic liver failure remain clinical problems with unacceptable morbidity and mortality. The development of extracorporeal liver support systems that replace the detoxification, synthetic, and regulatory functions of the native liver represent a long-sought potential solution, but all the devices currently available are still far from ideal. In general, artificial (cell-free) and bioartificial liver support devices have shown their ability to decrease some circulating toxins, to ameliorate hepatic encephalopathy and other intermediate variables, and to be relatively safe...
November 2014: Clinics in Liver Disease
https://www.readbyqxmd.com/read/25376162/is-the-molecular-adsorbent-recirculating-system-the-answer-for-children-with-acute-liver-failure
#18
EDITORIAL
Philip Rosenthal
No abstract text is available yet for this article.
March 2015: Liver Transplantation
https://www.readbyqxmd.com/read/25366362/experience-with-molecular-adsorbent-recirculating-system-treatment-in-20-children-listed-for-high-urgency-liver-transplantation
#19
REVIEW
Willem S Lexmond, Carin M L Van Dael, René Scheenstra, Joanne F Goorhuis, Egbert Sieders, Henkjan J Verkade, Patrick F Van Rheenen, Martin Kömhoff
For more than 10 years, children at our national center for pediatric liver transplantation (LT) have been treated with Molecular Adsorbent Recirculating System (MARS) liver dialysis as a bridging therapy to high-urgency LT. Treatment was reserved for 20 patients with the highest degrees of hepatic encephalopathy (HE; median grade = 3.5). Death from neurological sequelae was considered imminent for these patients, and this was further reflected in significantly higher international normalized ratios and ammonia levels and worse prognostic liver indices (Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease scores and liver injury units) in comparison with 32 wait-listed patients who did not receive MARS dialysis...
March 2015: Liver Transplantation
https://www.readbyqxmd.com/read/25032885/pharmacotherapy-for-hyperammonemia
#20
REVIEW
Anna Hadjihambi, Varun Khetan, Rajiv Jalan
INTRODUCTION: Hepatic encephalopathy (HE) is a serious neuropsychiatric complication that is seen in patients with liver failure. The pathogenesis of HE is not entirely understood, but several hypotheses have emerged and persisted during the years. Despite the many prevalent hypotheses, most of the existing evidence point to ammonia as the main culprit behind primary and secondary symptoms making it the center of potential therapeutic options for the treatment of HE. Most treatments of hyperammonemia target the organs and metabolic processes involved in ammonia detoxification...
August 2014: Expert Opinion on Pharmacotherapy
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