Mortality in patients with severe acute alcoholic hepatitis (AH) remains high, leading to interest in the use of extracorporeal liver support.
The molecular adsorbents recirculating system (MARS) is a liver support device in which the patient's blood is dialyzed across an albumin-impregnated membrane.
In this study, researchers from London, England, assessed the safety, efficacy and feasibility of using MARS in patients with severe AH.
The research team treated 8 patients with MARS. All patients were encephalopathic, 5 had Type 1 hepatorenal syndrome and 2 had Type 2.
|Significant improvements in serum bilirubin, creatinine, prothrombin time, and grade of encephalopathy were observed.|
|Journal of Hepatology|
The team performed clinical, biochemical and hemodynamic assessments.
The team discharged 5 patients from hospital, and 4 remained alive at 3-month follow-up. This compares with an estimated survival of about 20%.
The research team identified a significant improvement in serum bilirubin, creatinine, prothrombin time, and grade of encephalopathy.
In addition, sustained improvements in mean arterial pressure, systemic vascular resistance and cardiac output were observed.
Thrombocytopenia was the only MARS-related adverse event observed.
Dr Rajiv Jalan’s team concluded, “MARS resulted in improved liver biochemistry, cardiovascular hemodynamics, renal function and encephalopathy in patients with severe AH, with an apparent reduction in mortality”.
“On this basis, a multi-centre, randomized clinical trial has been initiated.”