The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre
Introduction and Objectives: Acute on chronic liver failure (ACLF) describe a state of severe liver dysfunction. Extracorporeal liver support (ECLS) is a system that performs filtration and detoxification functions within an external device with the goal of reducing mortality or bypassing liver tran...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
|
| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124002497 |
| _version_ | 1797272466953863168 |
|---|---|
| author | Raul Sosa-Martinez Karla Paola Perez-Lopez Elizabeth Buganza-Torio Mayra V. Ramos-Gomez |
| author_facet | Raul Sosa-Martinez Karla Paola Perez-Lopez Elizabeth Buganza-Torio Mayra V. Ramos-Gomez |
| author_sort | Raul Sosa-Martinez |
| collection | DOAJ |
| description | Introduction and Objectives: Acute on chronic liver failure (ACLF) describe a state of severe liver dysfunction. Extracorporeal liver support (ECLS) is a system that performs filtration and detoxification functions within an external device with the goal of reducing mortality or bypassing liver transplantation. The objective was to evaluate the effects of the molecular absorbent recirculating system (MARS) and single-pass albumin dialysis (SPAD) in patients with acute-on-chronic in a tertiary Mexican hospital. Materials and Patients: : Retrospectively, a search was performed in the internal electronic system with patients who required MARS or SPAD from 2016 to 2022. Results: The results show a total of 18 patients with the diagnosis of acute on chronic liver failure who received treatment with MARS or SPAD. It was observed that 50% of the patients were women, with a mean age of 37.8 years.The cause of the chronic liver disease was autoimmune hepatitis in 5 cases, 5 primary biliary cholangitis, 3 as cryptogenic cirrhosis, 2 viral, 1 hepatocarcinoma, 1 metabolism errors and 1 graft rejection. Within the support therapies used, it was found that 28% of the patients received MARS and 72% received SPAD, with a total of 49 sessions.Clinically 77% of patients experienced improvement in hepatic encephalopathy and 66% improvement in renal function. At the end of the 90-day follow-up period, an overall survival rate of 52.94% was recorded. Conclusions: These findings support the effectiveness of MARS and SPAD as viable ECLS options in patients with ACLF. The positive results in the improvement of encephalopathy and renal function, together with the survival rate, indicate the potential of these therapeutic approaches in the management of patients in this clinical setting. The sample size was small, which may affect the generalizability of the results. |
| first_indexed | 2024-03-07T14:29:46Z |
| format | Article |
| id | doaj.art-1e89cf506a8048e0866ea97153a15ba7 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-03-07T14:29:46Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-1e89cf506a8048e0866ea97153a15ba72024-03-06T05:26:15ZengElsevierAnnals of Hepatology1665-26812024-02-0129101455The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de NoviembreRaul Sosa-Martinez0Karla Paola Perez-Lopez1Elizabeth Buganza-Torio2Mayra V. Ramos-Gomez3Servicio de Gastroenterología, Centro Médico Nacional 20 de NoviembreServicio de Gastroenterología, Centro Médico Nacional 20 de NoviembreCentro de Trasplante Hepatico. Centro Médico Nacional 20 de Noviembre. MexicoServicio de Gastroenterología, Centro Médico Nacional 20 de NoviembreIntroduction and Objectives: Acute on chronic liver failure (ACLF) describe a state of severe liver dysfunction. Extracorporeal liver support (ECLS) is a system that performs filtration and detoxification functions within an external device with the goal of reducing mortality or bypassing liver transplantation. The objective was to evaluate the effects of the molecular absorbent recirculating system (MARS) and single-pass albumin dialysis (SPAD) in patients with acute-on-chronic in a tertiary Mexican hospital. Materials and Patients: : Retrospectively, a search was performed in the internal electronic system with patients who required MARS or SPAD from 2016 to 2022. Results: The results show a total of 18 patients with the diagnosis of acute on chronic liver failure who received treatment with MARS or SPAD. It was observed that 50% of the patients were women, with a mean age of 37.8 years.The cause of the chronic liver disease was autoimmune hepatitis in 5 cases, 5 primary biliary cholangitis, 3 as cryptogenic cirrhosis, 2 viral, 1 hepatocarcinoma, 1 metabolism errors and 1 graft rejection. Within the support therapies used, it was found that 28% of the patients received MARS and 72% received SPAD, with a total of 49 sessions.Clinically 77% of patients experienced improvement in hepatic encephalopathy and 66% improvement in renal function. At the end of the 90-day follow-up period, an overall survival rate of 52.94% was recorded. Conclusions: These findings support the effectiveness of MARS and SPAD as viable ECLS options in patients with ACLF. The positive results in the improvement of encephalopathy and renal function, together with the survival rate, indicate the potential of these therapeutic approaches in the management of patients in this clinical setting. The sample size was small, which may affect the generalizability of the results.http://www.sciencedirect.com/science/article/pii/S1665268124002497 |
| spellingShingle | Raul Sosa-Martinez Karla Paola Perez-Lopez Elizabeth Buganza-Torio Mayra V. Ramos-Gomez The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre Annals of Hepatology |
| title | The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre |
| title_full | The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre |
| title_fullStr | The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre |
| title_full_unstemmed | The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre |
| title_short | The use of molecular adsorbent recirculating system and single-pass albumin dialysis as liver support: The experience of the Centro Medico Nacional 20 de Noviembre |
| title_sort | use of molecular adsorbent recirculating system and single pass albumin dialysis as liver support the experience of the centro medico nacional 20 de noviembre |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124002497 |
| work_keys_str_mv | AT raulsosamartinez theuseofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT karlapaolaperezlopez theuseofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT elizabethbuganzatorio theuseofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT mayravramosgomez theuseofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT raulsosamartinez useofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT karlapaolaperezlopez useofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT elizabethbuganzatorio useofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre AT mayravramosgomez useofmolecularadsorbentrecirculatingsystemandsinglepassalbumindialysisasliversupporttheexperienceofthecentromediconacional20denoviembre |