Experiencia de uso de MARS® (Molecular adsorvent recirculating system) en pacientes con insuficiencia hepática en el Hospital Universitario Cruces

  1. Apodaca-López, Naiara 1
  2. Ganuza-Martínez, Eunate 1
  3. Martínez-Indart, Lorea 2
  4. Ruano-Suárez, María-Carmen 1
  5. Martínez-Ruiz, Alberto 1
  1. 1 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Ezkerraldea-Enkarterri-CrucesHospital Universitario Cruces. Servicio Anestesiología-Reanimación. Barakaldo, España
  2. 2 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Ezkerraldea-Enkarterri-CrucesHospital Universitario Cruces. Instituto de investigación BioCruces. Unidad de Epidemiologia Clínica. Barakaldo, España
Journal:
Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

ISSN: 0304-4858,  2173-2302

Year of publication: 2023

Volume: 120

Issue: 2

Pages: 60-65

Type: Article

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More publications in: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

Abstract

Background y Aims: The Molecular Adsorbent Recirculating System (MARS®) is used as a support therapy in liver failure. Our aim is to review the effects exerted by MARS® in patients with liver failure in our Reanimation Unit.Method: Retrospective observational study of MARS®. We analysed data prior and after therapy, concerning: effectiveness (total serum bilirubin, serum creatinine and impact on hepatic encephalopathy), hemodynamic stability (heart rate (HR) and mean arterial pressure (MAP)) and variables related to bleeding complications (haematocrit, platelet count and prothrombin index (PI)).Results: We found statistically significant decrease in total serum bilirubin, from 40.34 ±5.69 mg/dl to 25.27 ±7.22 mg/dl (p =0.02) and serum creatinine, at first, median1.66mg/ dl (IQR 1.28, 2.11) to 1.07 mg/dl (IQR 0.79, 1.39) (p =0.01). No significant differences were observed regarding the improvement of hepatic encephalopathy (p =0.99). No significant difference was found regarding HR (p = 0.33) and MAP (p =0.29). Significant statistical differences were also obtained for platelet count (p =0.01) and haematocrit (p =0.01), but not for PI (p =0.55).Conclusion: Liver support therapy with MARS system is a well-tolerated procedure with a low complication rate, in which both analytical and clinical improvements are observed. However, given the size and heterogeneity of the sample, a larger experience is needed and further prospective, randomised and controlled studies must be conducted.

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