Dializa albuminowa w systemie MARS – doświadczenia własne

Dariusz Węgrzyn¹, Agnieszka Kutwin-Chojnacka¹, Piotr Peszyński², Wioletta Węgrzyn³

Summary
Background. In cases of severe liver failure, transplantation is the only therapeutic solution. When organs are not immediately available, the use of liver assistance methods may be necessary. Bilirubin, fatty acids, bile acids and other toxins accumulating in the blood of liver failure patients cannot be removed by standard haemodialysis. For theses cases the molecular adsorbent recycling system (MARS) has been introduced. It is a cell-free, extracorporeal, liver assistance method for the removal of both albumin-bound and water-soluble endogenous toxins. Methods and results. We present the results of 11 albumin MARS dialyses performed in 6 liver failure patients, 5 men with alcoholic cirrhosis and 1 woman with Byler syndrome. The mean age of the patients was 43.2 years. All patients were in Child C-class condition and had a Pugh score of 12-14. Three patients who were admitted to the ICU in desperate condition, died during or immediately after dialysis. The other three, who were in somewhat better condition, improved markedly and were transferred to the low-dependency area, The rapidly increasing serum bilirubin concentration, present before the start of treatment, was successfully reversed. Conclusion. Bilirubin is effectively removed by MARS dialysis. Our data suggest that the efficacy of the treatment is related to the general condition of the patient.

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