logo_hcam

Revista Médica Científica CAMbios

Periodicidad semestral: flujo continuo.

ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)

Ver PDF (Spanish)
Ver HTML (Spanish)
Ver EPUB (Spanish)

Keywords

Fallo Hepático/terapia
Albúminas/uso terapéutico
Encefalopatía Hepática
Soluciones para Hemodiálisis/química
Adsorción
Unidades de Cuidados Intensivos

How to Cite

1.
Usefulness of the molecular adsorbent recirculating system in liver failure: “liver dialysis”: Revisión. Cambios rev. méd. [Internet]. 2022 Dec. 30 [cited 2025 Oct. 28];21(2):e-837. Available from: https://revistahcam.iess.gob.ec/index.php/cambios/article/view/837

Abstract

INTRODUCTION

Hepatic failure, whether acute or chronic, represents a challenge for the clinician since its complications entail a great mortality, this is even more complicated since the therapeutic options are limited, even many times it is not possible to access a timely liver transplant program to improve the survival of these patients,
Thus, a hepatic “dialysis” system known as molecular adsorbent recirculation system has been developed, which has a detoxification effect to eliminate substances that generate a noxa in the human body. OBJECTIVE. To understand the usefulness of the molecular adsorbent recirculating system in liver failure, to know its indications and complications. METHODOLOGY. A literature review was performed with a descriptive,
retrospective qualitative non-experimental qualitative approach, of papers dealing with the use of the MARS system to treat liver failure, with evidence from 2004 to 2021. The literature review was conducted in databases such as Pubmed, Embase, BVS, Google Scholar and Elsevier. RESULTS. Thirty articles were identified that met inclusion criteria from an original group of 343 articles reviewed. It has been
determined that the evidence on this system is mainly composed of case reports and there are few randomized controlled trials that employ its use, however, it has been determined that this system is a bridge to renal transplantation while the patient is stabilized in the Intensive Care Unit, decreasing the markers of liver failure. CONCLUSIONS. In Latin America its use is almost null, hence the need to understand the
mechanism of this novel system.

Ver PDF (Spanish)
Ver HTML (Spanish)
Ver EPUB (Spanish)

References

Shah NJ, Royer A, Salvador J. Acute Liver Failure. StatPearls [Internet]. StatPearls Publishing; 2021 [cited 2021

Nov 30]. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK482374/

Stravitz RT, Lee WM. Acute liver failure. The Lancet. 2019 Sep;394(10201):869–81.

DOI: 10.1016/S0140-6736(19)31894-X

Instituto Ecuatoriano de Estadística y Censos. Registro Estadístico de Defunciones Generales. Informe

provisional 2019. Ecuador: INEC; Reporte 2019: p.9. Disponible en:

https://www.ecuadorencifras.gob.ec/documentos/web-inec/Poblacion_y_Demografia/Nacimientos_Defunciones/2020/Boletin_%20tecnico_%20EDG%202019%20prov.pdf

INEC. Estadísticas vitales: Registro Estadístico de defunciones generales 2020. Ecuador: INEC; 2020 p. 33.

Report No.: 2020. Disponible en:

https://www.ecuadorencifras.gob.ec/documentos/web-inec/Poblacion_y_Demografia/Defunciones_Generales_2020/2021-06-10_Principales_resultados_EDG_2020_final.pdf

Tandon R, Froghi S. Artificial liver support systems. J Gastroenterol Hepatol. 2021 May;36 (5):1164–79. Available

from: Tandon R, Froghi S. Artificial liver support systems. J Gastroenterol Hepatol. 2021 May;36(5):1164–

DOI: 10.1111/jgh.15255

Benavente D, Orozco R, Buckel E, Silva G, Valdés S. Manejo de Falla Hepática Fulminante con MARS (diálisis

hepática con albúmina). Rev Med Clin Condes: 16:3; Jul 2005. 150-156. Disponible en:

https://pesquisa.bvsalud.org/portal/resource/pt/lil-419199

Bhatia SN, Underhill GH, Zaret KS, Fox IJ. Cell and tissue engineering for liver disease. Sci Transl Med [Internet].

Jul 16 [cited 2021 Nov 30];6(245). Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374645/

Contreras B J, Poniachik T J, Oksenberg R D, Cortés M C, Valera M JM, Cotera F A, et al. Diálisis con albúmina

MARS (Molecular Adsorbent Recirculating System) como puente para el trasplante hepático en insuficiencia

hepática fulminante: presentación de 3 casos. Rev Médica Chile [Internet]. 2004 May [cited 2021 Nov 30];132: 601-607. Available from:

https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000500010&lng=en&nrm=iso&tlng=en,%20doi.org/10.4067/S0034-98872004000500010

Bernal W, Wendon J. Acute Liver Failure. N Engl J Med. 2013 Dec 26; 369(26):2525–34. Available from:

https://pubmed.ncbi.nlm.nih.gov/24369077/10. Mitzner SR. Extracorporeal liver support-albumin dialysis with the Molecular Adsorbent Recirculating System (MARS). Ann Hepatol. 2011;10:S21–8. Available

from:

https://www.sciencedirect.com/science/article/pii/S1665268119316023?via%3Dihub

Weiss N, Jalan R, Thabut D. Understanding hepatic encephalopathy. Intensive Care Med. 2018

Feb;44(2):231–4. Available from:

https://pubmed.ncbi.nlm.nih.gov/28547522/

Holecek M. Ammonia and amino acid profiles in liver cirrhosis: Effects of variables leading to hepatic

encephalopathy. Nutrition. 2015 Jan;31(1):14–20. Available from:

https://pubmed.ncbi.nlm.nih.gov/25220875/

Romero-Gómez M, Montagnese S, Jalan R. Hepatic encephalopathy in patients with acute decompensation

of cirrhosis and acute-on-chronic liver failure. J Hepatol. 2015 Feb;62(2):437–47. DOI: 10.1016/j.jhep.2014.09.005.

Van de Kerkhove MP, Hoekstra R, Chamuleau RAFM, van Gulik TM. Clinical Application of Bioartificial

Liver Support Systems. Ann Surg. 2004 Aug; 240(2): 216–30.

DOI: 10.1097/01.sla.0000132986.75257.19

Stange J, Ramlow W, Mitzner S, Schmidt R, Klinkmann H. Dialysis against a Recycled Albumin Solution

Enables the Removal of Albumin-Bound Toxins. Artif Organs. 2008 Nov 12;17(9):809–13.

DOI: 10.1111/j.1525-1594.1993.tb00635.x

García Martínez JJ, Bendjelid K. Artificial liver support systems: what is new over the last decade?. Ann

Intensive Care. 2018 Nov 15;8(1): 109.

DOI: 10.1186/s13613-018-0453-z

Patzer J. Principles of Bound Solute Dialysis. Ther Apher Dial. 2006 Apr; 10(2): 118–24.

DOI: 10.1111/j.1744-9987.2006.00352.x

A. Kobashi-Margáin R, G. Gavilanes-Espinar J, Gutiérrez-Grabe Y, A. Gutiérrez-Jiménez Á, Chávez-Tapia

N, Ponciano-Rodríguez G, et al. Albumin dialysis with molecular adsorbent recirculating system (MARS) for

the treatment of hepatic encephalopathy in liver failure. Ann Hepatol. 2011;10: S70–6.

DOI: 10.1016/S1665-2681(19)31611-4

Chiu A, Chan LMY, Fan ST. Molecular adsorbent recirculating system treatment for patients with liver failure:

the Hong Kong experience. Liver Int. 2006 Aug;26 (6): 695–702. Available from:

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1478-3231.2006.01293.x

Sen S, Davies NA, Mookerjee RP, Cheshire LM, Hodges SJ, Williams R, et al. Pathophysiological effects

of albumin dialysis in acute-on-chronic liver failure: A randomized controlled study. Liver Transpl. 2004

Sep;10(9): 1109–19. Available from:

https://pubmed.ncbi.nlm.nih.gov/15350001/

Yarrarapu SNS, Sanghavi D. Molecular Adsorbent Recirculating System. StatPearls [Internet]. StatPearls

Publishing; May 30 2022. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK555939/

Saliba F. The Molecular Adsorbent Recirculating System (MARS®) in the intensive care unit: a rescue

therapy for patients with hepatic failure. Crit Care. 2006;10(1):118. Available from: https://ccforum.biomedcentral.com/articles/10.1186/cc4825

Vaid A, Chweich H, Balk EM, Jaber BL. Molecular Adsorbent Recirculating System as Artificial Support

Therapy for Liver Failure: A Meta-Analysis. ASAIO J.2012 Jan;58(1):51–9. Available from:

https://pubmed.ncbi.nlm.nih.gov/22210651/

Wittebole X, Hantson P. Use of the molecular adsorbent recirculating system (MARSTM) for the management

of acute poisoning with or without liver failure. Clin Toxicol. 2011 Nov;49(9):782–93. Available from: https://pubmed.ncbi.nlm.nih.gov/22077243/

Macía M, Avilés J, Morales S, Pérez F, Moreno A, Navarro J, et al. Eficacia de la diálisis con albúmina en

el tratamiento de los pacientes con insuficiencia hepática avanzada: primera experiencia en España con el sistema MARS. NEFROLOGÍA. Vol. XXI. Número 4. 2001. Disponible en:

https://www.revistanefrologia.com/espdf-X0211699501013686

Bañares R, Nevens F, Larsen FS, Jalan R, Albillos A, Dollinger M, et al. Extracorporeal albumin dialysis with

the molecular adsorbent recirculating system in acute-onchronic liver failure: The RELIEF trial. Hepatology. 2013

Mar;57(3): 1153–62. Available from:

https://pubmed.ncbi.nlm.nih.gov/23213075/

Camus C, Locher C, Saliba F, Goubaux B, Bonadona A, Lavayssiere L, et al. Outcome of patients treated with

molecular adsorbent recirculating system albumin dialysis: A national multicenter study. JGH Open. 2020 Aug;4(4): 757–63. Available from:

https://pubmed.ncbi.nlm.nih.gov/32782967/

Larsen FS. Artificial liver support in acute and acute-onchronic liver failure. Curr Opin Crit Care. 2019 Apr; 25(2): 187–91. Available from:

https://pubmed.ncbi.nlm.nih.gov/30672818/

Sparrelid E, Gilg S, van Gulik TM. Systematic review of MARS treatment in post-hepatectomy liver failure. HPB.

Jul; 22(7): 950–60. DOI: 10.1016/j.hpb.2020.03.013

Ecuador. Agencia de Aseguramiento de la Calidad de los Servicios de Salud y Medicina Prepagada. ARCSA. Centros especializados en salud renal con licencias emitidas. Ecuador: ARCSA; 2019 Jun. Disponible en: http://www.acess.gob.ec/wp-content/uploads/2019/08/Reporte-julio-Licenciamiento.pdf

 

The authors who publish in this journal accept the following conditions:

1. The authors retain the copyright and grant to the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM the right of the first publication, with the work registered with the Creative Commons attribution license, which allows third parties to use the published material provided that they mention the authorship of the work and the first publication in this journal.

2. Authors can make other independent and additional contractual agreements for the non-exclusive distribution of the version of the article published in this journal (for example, include it in an institutional repository or publish it in a book) as long as it clearly indicates that the work was published. for the first time in the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM.