Title:
Replacement therapy of liver detoxifying function by MARS in acute on chronic liver failure

Roberto Marangoni MD^none MD^none MD^none MD^none MD^none MD^none MD^none MD^none MD^none MD^none MD^none

Milan

E-mail address corresponding author:
rmarangoni@alice.it

Background:
The efficacy of MARS (Molecular Adsorbent Recirculating System) as replacement of the liver detoxifying function has already been reported in the literature.

Methods:
Based on these findings 10 patients affected by acute on chronic liver failure (4 affected by chronic hepatitis C, 4 by primary biliary cirrhosis, 1 by autoimmune cholangitis, 1 by primary cirrhosis) have been treated with 4 MARS sessions in 4 consecutive days. Together with other clinical signs, the patients lamented severe pruritus, refractory to a pharmalogical therapy and showed scratching skin lesions.

Results:
The results have been the following:1) remarkable removing of ammonia, bilirubin and bile acids (considered method efficacy markers) allowing a significant reduction of the blood concentrations of these molecules; 2) rise of cholinesterase and prothrombin activity as well as reduction of alkaline phoshphatase; 3) disappearance of the severe pruritus, an almost constant symptom in chronic liver diseases, especially with cholestasis, after 3 sessions of MARS treatment ( at the same time of the fall of plasma bile acid concentrations). One month after the end of the treatment cycle blood parameters appeared unchanged in 8 patients and slightly modified in 2, clinical conditions were satisfactory, pruritus was still absent and the scratching skin lesions were on the way of recovery.

Conclusion:
These results confirm that MARS is a very efficient method in the replacement of the liver detoxifying function.

Subject:
New Technologies

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