Acute
poisoning due to ingestion of hepatotoxic Amanita sp. mushrooms can result in a spectrum of symptoms, from mild gastrointestinal discomfort to life-threatening
acute liver failure. With conventional treatment, Amanita phalloides
mushroom poisoning carries a substantial risk of mortality and many patients require
liver transplantation. The molecular adsorbent recirculating system (MARS) is an
artificial liver support system that can partly compensate for the detoxifying function of the liver by removing
albumin-bound and water-soluble toxins from blood. This treatment has been used in
acute liver failure to enable native liver recovery and as a bridging treatment to
liver transplantation. The aim of the study is to evaluate the outcome of 10 patients with Amanita
mushroom poisoning who were treated with MARS. The study was a retrospectively analyzed case series. Ten adult patients with accidental Amanita
poisoning of varying severity were treated in a
liver disease specialized intensive care unit from 2001 to 2007. All patients received MARS treatment and standard medical
therapy for
mushroom poisoning. The demographic, laboratory, and clinical data from each patient were recorded upon admission. The one-year survival and need for
liver transplantation were documented. The median times from mushroom ingestion to
first-aid at a local hospital and to MARS treatment were 18 h (range 14-36 h) and 48 h (range 26-78 h), respectively. All 10 patients survived longer than one year. One patient underwent a successful
liver transplantation. No serious adverse side-effects were observed with the MARS treatment. In conclusion, MARS treatment seems to offer a safe and effective treatment option in Amanita
mushroom poisoning.