Molecular Adsorption Recirculating System (MARS)
What is the Molecular Adsorption Recirculating System?
The Molecular Adsorption Recirculating System (MARS) is an extracorporeal liver support therapy used in the management of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF). It is designed to remove both protein-bound and water-soluble toxins from the bloodstream using albumin dialysis. MARS works by passing the patient’s blood through a circuit that includes a specialized filter containing albumin and activated charcoal. As the blood passes through the filter, toxins such as bilirubin, ammonia, and various cytokines are adsorbed onto the albumin and charcoal particles, effectively removing them from the blood. The purified blood is then returned to the patient’s circulation. MARS therapy aims to support liver function by reducing toxin levels in the bloodstream, thereby improving patient outcomes and potentially bridging patients to liver transplantation or allowing time for liver recovery.
How does MARS dialysis work?
This therapy operates through a complex yet meticulously orchestrated process known as albumin dialysis. The procedure begins with the diversion of a portion of the patient’s blood from the body through a catheter inserted into a large vein, such as the femoral or jugular vein, directing it into the MARS circuit. Within the circuit, the diverted blood undergoes albumin dialysis, where it passes through a specialized filter containing human albumin. Albumin, a crucial blood protein, serves as the dialysate and effectively binds to various toxins present in the bloodstream, including both water-soluble substances and protein-bound toxins like bilirubin and bile acids. As the blood flows through the filter, these toxins are adsorbed onto the albumin particles, effectively purifying the blood. Subsequently, the purified blood then enters an activated charcoal column within the MARS circuit. Activated charcoal, with its highly porous structure and large surface area, acts as an effective adsorbent, capturing a broad spectrum of toxins, including bilirubin, bile acids, and various cytokines, further enhancing blood purification.
Finally, the blood, now thoroughly detoxified and rid of toxins, is returned to the patient’s circulation through another catheter inserted into a vein, thereby completing the MARS therapy cycle. Through the continuous circulation of the patient’s blood and the sophisticated mechanisms of albumin dialysis and activated charcoal adsorption, MARS therapy offers an advanced approach to liver support, aiming to improve patient outcomes and potentially bridge patients to liver transplantation or facilitate liver recovery in cases of acute liver failure or acute-on-chronic liver failure.
What are the benefits of Molecular Adsorption Recirculating System?
The Molecular Adsorbents Recirculating System offers several benefits for patients with acute liver failure or acute-on-chronic liver failure:
- Toxin Removal: MARS effectively removes a wide range of toxins from the bloodstream, including water-soluble substances, protein-bound toxins such as bilirubin and bile acids, and various cytokines. By continuously circulating the patient’s blood through the MARS circuit and utilizing albumin dialysis and activated charcoal adsorption, MARS therapy helps detoxify the blood and reduce the burden of toxins on the liver.
- Liver Support: MARS provides extracorporeal liver support by complementing the impaired detoxification function of the patient’s liver. This support is particularly crucial in cases of ALF or ACLF, where the liver is unable to adequately metabolize and eliminate toxins from the bloodstream. By removing toxins and supporting liver function, MARS therapy aims to improve patient outcomes and potentially prevent further liver damage.
- Hemodynamic Stability: MARS therapy can contribute to hemodynamic stability in critically ill patients with ALF or ACLF. Unlike traditional intermittent hemodialysis, which may lead to rapid fluid shifts and hemodynamic instability, MARS offers a slower and more gradual removal of toxins, reducing the risk of hemodynamic fluctuations and maintaining cardiovascular stability.
- Improved Patient Outcomes: By effectively removing toxins and providing liver support, MARS therapy has the potential to improve patient outcomes in cases of ALF or ACLF. This may include reducing the severity of liver dysfunction, preventing progression to multiorgan failure, and increasing the likelihood of patient survival while awaiting liver transplantation or liver recovery.
- Bridge to Transplantation: In patients awaiting liver transplantation, MARS therapy can serve as a bridge therapy by stabilizing the patient’s condition, improving liver function, and reducing the severity of hepatic encephalopathy and other complications associated with ALF or ACLF. This may increase the patient’s eligibility for transplantation and improve transplant outcomes.
The Molecular Adsorption Recirculating System represents a cutting-edge extracorporeal liver support therapy designed to manage acute liver failure or acute-on-chronic liver failure. Through its sophisticated process of albumin dialysis and activated charcoal adsorption, MARS effectively removes a wide array of toxins from the bloodstream, including protein-bound and water-soluble substances, as well as various cytokines. This detoxification process not only alleviates the burden on the impaired liver but also supports liver function, contributes to hemodynamic stability, and ultimately aims to improve patient outcomes. By offering a comprehensive approach to liver support and toxin removal, MARS therapy serves as a valuable tool in the management of ALF and ACLF, potentially bridging patients to liver transplantation or facilitating liver recovery while awaiting further intervention.