Usefulness and safety of extracorporeal liver support therapy using MARSR for patients with liver failure: a preliminary report

Jong Won Choi, Ki Tae Yoon, Jun Yong Park, Ja Kyung Kim, Sang Hoon Ahn, Yong Han Paik, Kwan Sik Lee, Kwang Hyub Han, Chae Yoon Chon, Do Young Kim

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3 Citations (Scopus)

Abstract

BACKGROUND/AIMS: The molecular adsorbent recirculating system (MARSR) is a form of artificial extracorporeal liver support and can be used for a bridge to spontaneous recovery of hepatic function or liver transplantation in patients with liver failure. This study evaluated the usefulness of MARSR in patients with liver failure. METHODS: Between January 2004 and July 2007, 30 patients (21 males and 7 females; age 48.9+/-12.9 years) with acute or acute-on-chronic liver failure were managed using MARSR. We assessed laboratory data, the grade of hepatic encephalopathy, Child-Turcotte-Pugh class, and Model for End-Stage Liver Disease (MELD) score. RESULTS: The number of patients with acute liver failure and acute-on-chronic liver failure was 16 and 14, respectively. The mean cycle of MARSR in patients with liver failure was 2.2 sessions. After MARSR had been performed, serum total bilirubin, alanine aminotransferase (ALT), BUN, creatinine, ammonia level, daily urine output, and MELD score were improved (p<0.05). In contrast, MARSR failed to improve Child-Turcotte-Pugh score and the grade of hepatic encephalopathy. Liver transplantation was performed in 8 patients. Among them, 5 (62.5%) patients survived and 3 (37.5%) patients died. Twenty two patients underwent MARSR without liver transplantation and 4 (18.2%) of them survived. CONCLUSIONS: In patients with liver failure, MARSR improved the laboratory data and hepatic and renal function associated clinical characteristics. However, MARSR without liver transplantation did not improve survival. MARSR may be useful as a bridge therapy to liver transplantation in patients with liver failure.

Original languageEnglish
Pages (from-to)28-35
Number of pages8
JournalThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume54
Issue number1
DOIs
Publication statusPublished - 2009 Jul

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Liver Failure
Safety
Liver
Liver Transplantation
Therapeutics
End Stage Liver Disease
Hepatic Encephalopathy
Artificial Liver
Acute Liver Failure
Blood Urea Nitrogen
Recovery of Function
Alanine Transaminase
Bilirubin
Ammonia
Creatinine
Urine
Kidney

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Usefulness and safety of extracorporeal liver support therapy using MARSR for patients with liver failure: a preliminary report",
abstract = "BACKGROUND/AIMS: The molecular adsorbent recirculating system (MARSR) is a form of artificial extracorporeal liver support and can be used for a bridge to spontaneous recovery of hepatic function or liver transplantation in patients with liver failure. This study evaluated the usefulness of MARSR in patients with liver failure. METHODS: Between January 2004 and July 2007, 30 patients (21 males and 7 females; age 48.9+/-12.9 years) with acute or acute-on-chronic liver failure were managed using MARSR. We assessed laboratory data, the grade of hepatic encephalopathy, Child-Turcotte-Pugh class, and Model for End-Stage Liver Disease (MELD) score. RESULTS: The number of patients with acute liver failure and acute-on-chronic liver failure was 16 and 14, respectively. The mean cycle of MARSR in patients with liver failure was 2.2 sessions. After MARSR had been performed, serum total bilirubin, alanine aminotransferase (ALT), BUN, creatinine, ammonia level, daily urine output, and MELD score were improved (p<0.05). In contrast, MARSR failed to improve Child-Turcotte-Pugh score and the grade of hepatic encephalopathy. Liver transplantation was performed in 8 patients. Among them, 5 (62.5{\%}) patients survived and 3 (37.5{\%}) patients died. Twenty two patients underwent MARSR without liver transplantation and 4 (18.2{\%}) of them survived. CONCLUSIONS: In patients with liver failure, MARSR improved the laboratory data and hepatic and renal function associated clinical characteristics. However, MARSR without liver transplantation did not improve survival. MARSR may be useful as a bridge therapy to liver transplantation in patients with liver failure.",
author = "Choi, {Jong Won} and Yoon, {Ki Tae} and Park, {Jun Yong} and Kim, {Ja Kyung} and Ahn, {Sang Hoon} and Paik, {Yong Han} and Lee, {Kwan Sik} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Kim, {Do Young}",
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Usefulness and safety of extracorporeal liver support therapy using MARSR for patients with liver failure : a preliminary report. / Choi, Jong Won; Yoon, Ki Tae; Park, Jun Yong; Kim, Ja Kyung; Ahn, Sang Hoon; Paik, Yong Han; Lee, Kwan Sik; Han, Kwang Hyub; Chon, Chae Yoon; Kim, Do Young.

In: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, Vol. 54, No. 1, 07.2009, p. 28-35.

Research output: Contribution to journalArticle

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T1 - Usefulness and safety of extracorporeal liver support therapy using MARSR for patients with liver failure

T2 - a preliminary report

AU - Choi, Jong Won

AU - Yoon, Ki Tae

AU - Park, Jun Yong

AU - Kim, Ja Kyung

AU - Ahn, Sang Hoon

AU - Paik, Yong Han

AU - Lee, Kwan Sik

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Kim, Do Young

PY - 2009/7

Y1 - 2009/7

N2 - BACKGROUND/AIMS: The molecular adsorbent recirculating system (MARSR) is a form of artificial extracorporeal liver support and can be used for a bridge to spontaneous recovery of hepatic function or liver transplantation in patients with liver failure. This study evaluated the usefulness of MARSR in patients with liver failure. METHODS: Between January 2004 and July 2007, 30 patients (21 males and 7 females; age 48.9+/-12.9 years) with acute or acute-on-chronic liver failure were managed using MARSR. We assessed laboratory data, the grade of hepatic encephalopathy, Child-Turcotte-Pugh class, and Model for End-Stage Liver Disease (MELD) score. RESULTS: The number of patients with acute liver failure and acute-on-chronic liver failure was 16 and 14, respectively. The mean cycle of MARSR in patients with liver failure was 2.2 sessions. After MARSR had been performed, serum total bilirubin, alanine aminotransferase (ALT), BUN, creatinine, ammonia level, daily urine output, and MELD score were improved (p<0.05). In contrast, MARSR failed to improve Child-Turcotte-Pugh score and the grade of hepatic encephalopathy. Liver transplantation was performed in 8 patients. Among them, 5 (62.5%) patients survived and 3 (37.5%) patients died. Twenty two patients underwent MARSR without liver transplantation and 4 (18.2%) of them survived. CONCLUSIONS: In patients with liver failure, MARSR improved the laboratory data and hepatic and renal function associated clinical characteristics. However, MARSR without liver transplantation did not improve survival. MARSR may be useful as a bridge therapy to liver transplantation in patients with liver failure.

AB - BACKGROUND/AIMS: The molecular adsorbent recirculating system (MARSR) is a form of artificial extracorporeal liver support and can be used for a bridge to spontaneous recovery of hepatic function or liver transplantation in patients with liver failure. This study evaluated the usefulness of MARSR in patients with liver failure. METHODS: Between January 2004 and July 2007, 30 patients (21 males and 7 females; age 48.9+/-12.9 years) with acute or acute-on-chronic liver failure were managed using MARSR. We assessed laboratory data, the grade of hepatic encephalopathy, Child-Turcotte-Pugh class, and Model for End-Stage Liver Disease (MELD) score. RESULTS: The number of patients with acute liver failure and acute-on-chronic liver failure was 16 and 14, respectively. The mean cycle of MARSR in patients with liver failure was 2.2 sessions. After MARSR had been performed, serum total bilirubin, alanine aminotransferase (ALT), BUN, creatinine, ammonia level, daily urine output, and MELD score were improved (p<0.05). In contrast, MARSR failed to improve Child-Turcotte-Pugh score and the grade of hepatic encephalopathy. Liver transplantation was performed in 8 patients. Among them, 5 (62.5%) patients survived and 3 (37.5%) patients died. Twenty two patients underwent MARSR without liver transplantation and 4 (18.2%) of them survived. CONCLUSIONS: In patients with liver failure, MARSR improved the laboratory data and hepatic and renal function associated clinical characteristics. However, MARSR without liver transplantation did not improve survival. MARSR may be useful as a bridge therapy to liver transplantation in patients with liver failure.

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