Molecular adsorbent recirculating system in patients with early allograft dysfunction after liver transplantation: A pilot study

✍ Scribed by Hubert Hetz; Peter Faybik; Gabriela Berlakovich; Amir Baker; Andreas Bacher; Christopher Burghuber; Sigrid E. Sandner; Heinz Steltzer; Claus Georg Krenn

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 105 KB
• Volume: 12
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20804

✦ Synopsis

Early allograft dysfunction (EAD) after orthotopic liver transplantation (OLT) causes marked morbidity and mortality. We conducted a prospective pilot study to assess the safety and efficacy of molecular adsorbent recirculating system (MARS) in treatment of EAD after OLT. Twelve consecutive adult liver allograft recipients with a median age of 48 years, 9 of whom were male, were prospectively included and supported with MARS. EAD was defined as the presence of at least 2 of the following: serum bilirubin Ͼ10 mg/dL, prothrombin time Ͻ40%, aspartate aminotransferase or alanine transferase Ͼ1,000 U/L, and plasma disappearance rate of indocyanine green (PDR ICG ) Ͻ10% per minute within 72 hours after reperfusion. One-year patient and graft survival was 66%. There was a significant decrease in serum bilirubin (P ϭ 0.002), serum creatinine (P ϭ 0.006), and aspartate aminotransferase (P ϭ 0.005) and a significant increase in PDR ICG (P ϭ 0.007) after MARS treatment. Prothrombin time, albumin level, and platelet count remained stable. Sustained improvement of renal and neurological function and of mean arterial pressure were observed. No MARS-related adverse effects occurred. MARS treatment provides a safe approach to the treatment of EAD after OLT. On the basis of this pilot study, a multicenter randomized clinical trial that uses MARS treatment in EAD after OLT has been initiated.