Premium
Molecular adsorbent recirculating system in patients with early allograft dysfunction after liver transplantation: A pilot study
Author(s) -
Hetz Hubert,
Faybik Peter,
Berlakovich Gabriela,
Baker Amir,
Bacher Andreas,
Burghuber Christopher,
Sandner Sigrid E.,
Steltzer Heinz,
Krenn Claus Georg
Publication year - 2006
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20804
Subject(s) - medicine , bilirubin , liver transplantation , gastroenterology , prothrombin time , liver function , creatinine , liver function tests , albumin , adverse effect , indocyanine green , renal function , surgery , transplantation , urology
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 >10 mg/dL, prothrombin time <40%, aspartate aminotransferase or alanine transferase >1,000 U/L, and plasma disappearance rate of indocyanine green (PDR ICG ) <10% per minute within 72 hours after reperfusion. One‐year patient and graft survival was 66%. There was a significant decrease in serum bilirubin ( P = 0.002), serum creatinine ( P = 0.006), and aspartate aminotransferase ( P = 0.005) and a significant increase in PDR ICG ( P = 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. Liver Transpl 12:1357‐1364, 2006. © 2006 AASLD.