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Molecular adsorbant recirculating system

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https://www.readbyqxmd.com/read/28887736/a-comparison-among-three-different-apheretic-techniques-for-treatment-of-hyperbilirubinemia
#1
Davide Viggiano, Emanuela de Pascale, Gaia Marinelli, Corrado Pluvio
Liver failure is associated to high mortality due to the accumulation of protein-bound metabolites, such as bilirubin, not removed by conventional hemodialysis. Different methods can efficiently remove them, such as the molecular adsorbent recirculating system (MARS), plasma exchange (PEX), and bilirubin or plasma adsorption perfusion (PAP). No direct comparison exists between MARS, PEX and PAP, and current guidelines do not specify which method (and when) to use. We have retrospectively evaluated MARS, PEX and PAP in their effectiveness in lowering plasma bilirubin concentration, and their effects on liver and kidney function...
September 8, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28692474/molecular-adsorbent-recirculating-system-effectively-replaces-hepatic-function-in-severe-acute-liver-failure
#2
Steven I Hanish, Deborah M Stein, Joseph R Scalea, Eno-Obong Essien, Paul Thurman, William R Hutson, Stephen T Bartlett, Rolf N Barth, Thomas M Scalea
BACKGROUND DATA: Patients with severe acute liver failure (ALF) have extreme physiologic dysfunction and often die if transplantation is not immediately available. Patients may be supported with MARS (Baxter International Inc., Deerfield, IL) until transplantation or spontaneous recovery occurs. We present the largest series in the United States of MARS therapy as temporary hepatic replacement for ALF. METHODS: MARS was used to support patients with severe liver trauma (SLT), in ALF patients as a bridge to transplantation (BTT), and as definitive therapy for toxic ingestion or idiopathic liver failure (DT) in a level 1 trauma center and large transplant center...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28640024/molecular-adsorbent-recirculating-system-can-reduce-short-term-mortality-among-patients-with-acute-on-chronic-liver-failure-a-retrospective-analysis
#3
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Anna Hüsing-Kabar, Christian Wilms, Miriam Maschmeier, Iyad Kabar, Josep Torner, Marco Pavesi, Vicente Arroyo, Rafael Banares, Hartmut H J Schmidt
OBJECTIVES: Acute-on-chronic liver failure is associated with numerous consecutive organ failures and a high short-term mortality rate. Molecular adsorbent recirculating system therapy has demonstrated beneficial effects on the distinct symptoms, but the associated mortality data remain controversial. DESIGN: Retrospective analysis of acute-on-chronic liver failure patients receiving either standard medical treatment or standard medical treatment and molecular adsorbent recirculating system...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403210/molecular-adsorbent-recirculating-system-mars-in-acute-liver-injury-and-graft-dysfunction-results-from-a-case-control-study
#4
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Christian Wilms, Anna Hüsing-Kabar, Dennis Görlich, Iyad Kabar, Hartmut H J Schmidt
BACKGROUND: The 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. AIM: We 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)...
2017: PloS One
https://www.readbyqxmd.com/read/28337775/effectiveness-and-safety-assessment-of-citrate-anticoagulation-during-albumin-dialysis-in-comparison-to-other-methods-of-anticoagulation
#5
Agnieszka Dyla, Wojciech Mielnicki, Joanna Bartczak, Tomasz Zawada, Piotr Garba
Liver failure is a serious and often deadly disease often requiring MARS (Molecular Adsorbent Recirculating System) therapy. Choosing the safe and effective method of anticoagulation during artificial liver support systems seems to be very difficult and extremely important. The aim of this study was to assess effectiveness and safety of regional anticoagulation with citrate in liver failure patients during MARS. We used a single center observational study. We analyzed 158 MARS sessions performed in 65 patients: 105 (66...
March 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28248208/extracorporeal-liver-support-systems-in-paediatric-liver-failure
#6
Vandana Jain, Anil Dhawan
Extracorporeal liver support systems (ELSS), encompassing artificial and bioartificial devices, have been used for decades, with the aim of supporting patients with acute liver failure and acute-on chronic liver failure, as a bridge to recovery (acute liver failure only) or liver transplantation, in an era of organ donation shortage. Although biochemical efficacy has been consistently demonstrated by these devices, translation into clinical and survival benefits has been unclear, due to study limitations and lack of reliable prognostic scoring in liver failure...
June 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28167225/no-child-left-behind-liver-transplantation-in-critically-ill-children
#7
Abbas Rana, Michael Kueht, Moreshwar Desai, Fong Lam, Tamir Miloh, Jennifer Moffett, N Thao N Galvan, Ronald Cotton, Christine O'Mahony, John Goss
BACKGROUND: Advances in critical care prolong survival in children with liver failure, allowing more critically ill children to undergo orthotopic liver transplantation (OLT). In order to justify the use of a scarce donor resource and avoid futile transplants, we sought to determine survival in children who undergo OLT while receiving pre-OLT critical care. STUDY DESIGN: We analyzed 13,723 pediatric OLTs using the United Network for Organ Sharing (UNOS) database from 1987 to 2015, including 6,746 recipients in the Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease (MELD/PELD) era (2002 to 2015)...
April 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#8
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)...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27851331/1696-reversal-of-calcium-channel-blocker-toxicity-with-molecular-adsorbents-recirculating-system
#9
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
#10
Qing Zhang, Yanxing Guan, Tianxin Xiang, Shaozheng Liu, Qingjie Chen, Qing Zhang
OBJECTIVE: The treatment of hyperthyroidism associated with severe liver dysfunction (LD) is a clinical challenge, and there has been no unified examination of this problem. The objective of this study was to assess the efficacy and safety of radioiodine ((131)I) in combination with a molecular adsorbent recirculating system (MARS) for the treatment of hyperthyroidism complicated by severe liver LD. METHODS: A total of 116 hyperthyroidism patients with concomitant LD who received MARS treatment were studied retrospectively...
February 2017: Endocrine Practice
https://www.readbyqxmd.com/read/27740530/%C3%A2-albumin-dialysis-with-mars-for-the-treatment-of-anabolic-steroid-induced-cholestasis
#11
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
#12
REVIEW
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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