Despite improvement in
critical care,
liver failure is still associated with high mortality. Therapeutic concepts are aimed at restoring endogenous liver function or to bridge the time to
liver transplantation. In addition to standard medical treatment, extracorporeal liver support with
albumin dialysis is used for this purpose. The aim of this study was to analyze the efficacy of single pass
albumin dialysis (
SPAD) in comparison to the molecular adsorbent recirculating system (MARS) in patients treated at our university hospital intensive care unit between July 2004 and August 2008. In this retrospective analysis we studied patients presenting with
liver failure who were treated with
albumin dialysis. Laboratory parameters, daily health scoring, the number of transfusions, and mortality were recorded. The (paired) t-test, Mann-Whitney U-test, and Wilcoxon test were used for statistical analysis. In all, 163
albumin dialysis treatments, 126 with MARS and 37 with
SPAD, in 57 patients were performed. MARS resulted in a significant decrease in
bilirubin (-38 +/- 66.5 micromol/L from a baseline of 301 +/- 154.6 micromol/L),
gamma-glutamyltransferase (gamma-GT),
alanine aminotransferase,
creatinine, and
urea.
SPAD resulted in a significant decrease in
bilirubin (-41 +/- 111.2 micromol/L from a baseline of 354 +/- 189.4 micromol/L) and gamma-GT, while
lactate levels increased. No differences in the need for
blood transfusion, health scoring, or mortality between the two treatment modalities were detected. This retrospective analysis suggests equal efficacy of MARS and
SPAD; however, prospective assessment to further define the role of
SPAD in the treatment of acute or
acute-on-chronic liver failure is needed.