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[The treatment of molecular adsorbents recirculating system artificial liver in severe liver failure patients with multiple organ dysfunction syndrome].

AbstractOBJECTIVE:
To evaluate the effectiveness and mechanisms of molecular adsorbents recirculating system (MARS) treatment in severe liver failure patients with multiple organ dysfunction syndrome (MODS).
METHODS:
60 single MARS treatments were performed for 6 - 24 hours on 24 severe liver failure patients with MODS.
RESULTS:
MARS therapy was associated with marked reduction of albumin bound toxins and water soluble toxins, together with a significant removal of NO and certain cytokines, such as TNF-alpha, IL-6, IL-8, and INF-gamma. These were associated with a improvement of the patients' clinical conditions including hepatic encephalopathy, deranged hemodynamic situation, as well as renal and respiratory function, thus resulted into marked decrease of sequential organ failure assessment (SOFA) score (from 9.72+-1.89 to 6.98+-2.34), and improving outcome: 9 patients were able to be discharged from the hospital or bridged to successful liver transplantation. The overall survival rate of 24 patients was 37.5%.
CONCLUSIONS:
There is positive therapeutic impact and safety to use MARS on liver failure patients with MODS. The effectiveness of MARS is correlated with reducing the levels of NO and cytokines, except for completely removing of accumulated toxins in liver failure patients.
AuthorsLi-min Guo, Jing-yuan Liu, Dao-zhen Xu, Bao-shun Li, Hao Han, Ling-hang Wang, Wei-yan Zhang, Lian-he Lu, Xia Guo, Feng-xia Sun, Hong-yu Zhang, Xiao-dong Liu, Jian-ping Zhang, Jun Yao, Zhong-ping He, Min-min Wang
JournalZhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology (Zhonghua Gan Zang Bing Za Zhi) Vol. 11 Issue 8 Pg. 455-7 (Aug 2003) ISSN: 1007-3418 [Print] China
PMID12939172 (Publication Type: English Abstract, Journal Article)
Chemical References
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Nitric Oxide
  • Interferon-gamma
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bioreactors
  • Female
  • Humans
  • Interferon-gamma (blood)
  • Interleukin-6 (blood)
  • Interleukin-8 (blood)
  • Liver Failure, Acute (blood, therapy)
  • Liver, Artificial
  • Male
  • Middle Aged
  • Multiple Organ Failure (therapy)
  • Nitric Oxide (blood)
  • Sorption Detoxification (instrumentation, methods)
  • Tumor Necrosis Factor-alpha (metabolism)

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