Int J Artif Organs. 2006 Jul;29(7):660-7.
Chiu A, Fan ST.
Intensive Care Unit, Queen Mary Hospital, and Department of Surgery, University
of Hong Kong, China.
Molecular Adsorbent Recirculation System (MARS) is a form of extracorporeal
detoxification system used as an artificial liver support system. Numerous
studies have been published on the topic, with the majority of them describing
the capability of MARS in removing albumin-bound toxins and improving systemic
hemodynamics. Whether such improvement could be translated into survival benefit
is still uncertain, given the paucity of randomized controlled trials available.
The outcome of patients receiving MARS treatment is difficult to analyze because
liver failure patients constitute a heterogeneous population and different
subgroups carry different prognoses. An evidence-based recommendation on the
timing of MARS initiation is not available and currently MARS is usually
commenced for hyperbilirubinemia or presence of complications of liver failure.
MARS is in general a safe procedure, but there are still potential complications
that need to be cautioned, along with various operative issues that are worth
attention. The future prospects of MARS would rely on the completion of
adequately powered randomized controlled trials.