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- Title
Preconditioning by extracorporeal liver support (MARS) of patients with cirrhosis and severe liver failure evaluated for living donor liver transplantation – a pilot study.
- Authors
Jong Young Choi; Si Hyun Bae; Seung Kew Yoon; Se Hyun Cho; Jin Mo Yang; Joon Yeol Han; Byung Min Ahn; Kyu Won Chung; Hee Sik Sun; Dong Goo Kim
- Abstract
Choi JY, Bae SH, Yoon SK, Cho SH, Yang JM, Han JY, Ahn BM, Chung KW, Sun HS, Kim DG. Preconditioning by extracorporeal liver support (MARS) of patients with cirrhosis and severe liver failure evaluated for living donor liver transplantation – a pilot study. Liver International 2005: 25: 740–745. © Blackwell Munksgaard 2005 The aim of this prospective study was to evaluate the effectiveness of preconditioning molecular adsorbent recirculating system (MARS) treatment on patients with acute-on-chronic liver failure (AoCLF), who were awaiting living donor liver transplantation (LDLT). Between January and December 2001, 10 consecutive AoCLF patients (with progressive hyperbilirubinemia (>20 mg/dl) and hepatic encephalopathy grade ≥2) were studied. MARS was used in eight of these patients who were evaluated for LDLT during 2001. Three AoCLF patients who received LDLT before clinical use of MARS were used as historical controls. Because of a shortage of donors, only five out of 10 patients considered for LDLT could receive transplants. Three patients were treated with MARS for 8 h the day before receiving LDLT, and all three survived. The remaining two patients who received transplants, and who were not pretreated with MARS, died from sepsis and multi-organ failure within 2 weeks. Four of the patients who did not receive transplants because of donor shortage died despite 1 or 3 MARS treatments, however bilirubin levels and grade of encephalopathy were significantly reduced in these patients. Results of this small pilot study suggest that MARS, by reducing the severity of jaundice and encephalopathy, might be effective as a bridging option in AoCLF patients awaiting LDLT.
- Subjects
ABDOMEN; LIVER failure; DISEASE complications; LIVER diseases; LIVER transplantation; BILIRUBIN; SEPSIS
- Publication
Liver International, 2005, Vol 25, Issue 4, p740
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/j.1478-3231.2005.01074.x