Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City

Acute liver failure is a clinical condition associated with high mortality despite recent technological advances. Supportive devices such as the Molecular Adsorbents Recirculating System (MARS®) provide therapeutic strategies to add time to find an organ for orthotopic liver transplantation or to al...

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Main Authors: Nahum Mendez-Sanchez, Norberto C. Chavez-Tapia, Beatriz Espinoza, Magali Herrera-Gomar, Daniel Zamora-Valdes, Misael Uribe
Format: Article
Language:English
Published: Elsevier 2004-10-01
Series:Annals of Hepatology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1665268119320964
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spelling doaj-80ecb7e60ce243f7b4e7d93110e9784c2021-06-08T04:36:38ZengElsevierAnnals of Hepatology1665-26812004-10-0134164166Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico CityNahum Mendez-Sanchez0Norberto C. Chavez-Tapia1Beatriz Espinoza2Magali Herrera-Gomar3Daniel Zamora-Valdes4Misael Uribe5Liver Research Unit. Medica Sur Clinic & Foundation, Mexico City, Mexico; Address for correspondence:Liver Research Unit. Medica Sur Clinic & Foundation, Mexico City, MexicoLiver Research Unit. Medica Sur Clinic & Foundation, Mexico City, MexicoLiver Research Unit. Medica Sur Clinic & Foundation, Mexico City, MexicoLiver Research Unit. Medica Sur Clinic & Foundation, Mexico City, MexicoLiver Research Unit. Medica Sur Clinic & Foundation, Mexico City, MexicoAcute liver failure is a clinical condition associated with high mortality despite recent technological advances. Supportive devices such as the Molecular Adsorbents Recirculating System (MARS®) provide therapeutic strategies to add time to find an organ for orthotopic liver transplantation or to allow the native liver to recover sufficiently to make transplantation unnecessary. In this series of cases, we discuss our initial experiences with three patients with acute liver failure. One patient had high bilirubin levels caused by Epstein-Barr virus infection and responded well after three MARS sessions. In a second patient, MARS therapy was used to treat acute-on-chronic liver failure caused by chronic hepatitis B virus infection that had not been treated previously; because of severe hemodynamic compromise, only one MARS session was performed. The third patient had an initial diagnosis of acute liver failure and cryptogenic hepatitis, and was treated with five MARS sessions as a supportive measure until the definitive diagnosis (metastatic disease) was performed. In all patients, MARS therapy was well tolerated and induced only mild hypokalemia. In conclusion, although MARS therapy was an effective strategy for these cases of liver failure and greatly improved the biochemical variables, its impact on the mortality rate has not yet been determined.http://www.sciencedirect.com/science/article/pii/S1665268119320964Liver failurecholestasismolecular adsorbents recirculating systemEpstein-Barr virushypokalemia
collection DOAJ
language English
format Article
sources DOAJ
author Nahum Mendez-Sanchez
Norberto C. Chavez-Tapia
Beatriz Espinoza
Magali Herrera-Gomar
Daniel Zamora-Valdes
Misael Uribe
spellingShingle Nahum Mendez-Sanchez
Norberto C. Chavez-Tapia
Beatriz Espinoza
Magali Herrera-Gomar
Daniel Zamora-Valdes
Misael Uribe
Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City
Annals of Hepatology
Liver failure
cholestasis
molecular adsorbents recirculating system
Epstein-Barr virus
hypokalemia
author_facet Nahum Mendez-Sanchez
Norberto C. Chavez-Tapia
Beatriz Espinoza
Magali Herrera-Gomar
Daniel Zamora-Valdes
Misael Uribe
author_sort Nahum Mendez-Sanchez
title Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City
title_short Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City
title_full Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City
title_fullStr Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City
title_full_unstemmed Acute liver failure and the molecular adsorbents recirculating system: Early experience in a tertiary care hospital in Mexico City
title_sort acute liver failure and the molecular adsorbents recirculating system: early experience in a tertiary care hospital in mexico city
publisher Elsevier
series Annals of Hepatology
issn 1665-2681
publishDate 2004-10-01
description Acute liver failure is a clinical condition associated with high mortality despite recent technological advances. Supportive devices such as the Molecular Adsorbents Recirculating System (MARS®) provide therapeutic strategies to add time to find an organ for orthotopic liver transplantation or to allow the native liver to recover sufficiently to make transplantation unnecessary. In this series of cases, we discuss our initial experiences with three patients with acute liver failure. One patient had high bilirubin levels caused by Epstein-Barr virus infection and responded well after three MARS sessions. In a second patient, MARS therapy was used to treat acute-on-chronic liver failure caused by chronic hepatitis B virus infection that had not been treated previously; because of severe hemodynamic compromise, only one MARS session was performed. The third patient had an initial diagnosis of acute liver failure and cryptogenic hepatitis, and was treated with five MARS sessions as a supportive measure until the definitive diagnosis (metastatic disease) was performed. In all patients, MARS therapy was well tolerated and induced only mild hypokalemia. In conclusion, although MARS therapy was an effective strategy for these cases of liver failure and greatly improved the biochemical variables, its impact on the mortality rate has not yet been determined.
topic Liver failure
cholestasis
molecular adsorbents recirculating system
Epstein-Barr virus
hypokalemia
url http://www.sciencedirect.com/science/article/pii/S1665268119320964
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