While undergoing MARS® therapy, the patient is
connected to a conventional hemodialysis or
CRRT machine (i.e. Prisma) driving the blood through an extracorporeal circuit into a MARS® Flux dialyzer. In comparison to renal replacement therapies, the patient’s blood is dialyzed against a recirculating human albumin solution rather than against a bicarbonate-based dialysate.
Once the toxins are transported across the MARS® Flux membrane and bound to the albumin contained in the dialysate, the solution is dialyzed in a conventional low-flux dialyzer against a standard bicarbonate dialysate removing all water-soluble substances from the albumin solution. The albumin solution then passes through two adsorber columns designed to extract the albumin-bound toxins, thus regenerating the solution so that it can return to the MARS® Flux dialyzer for additional removal of toxins such as:
• Ammonia
• Billirubin
• Bile acids
• Aromatic Aminoacids
• Short and middle chain fatty acids
• Tryptophan
• Copper
• Iron
• Creatinine
• Urea
• Diazepam
• Benzodiazepine like substances
• Nitric oxide
• Phenytoin
The MARS® system has shown in several randomized controlled trials to improve short term survival, hepatic encephalopathy, hemodynamics, intracranial pressure and coagulopathy in patients with liver failure of different conditions including:
• “Acute on chronic” liver failure, a situation where patients with chronic liver diseases suffer an acute decompensation due to a precipitating event such as an infection or a bleeding complication.
• Acute liver failure (including paracetamol intoxication)
• Intractable pruritus in cholestasis
• Graft dysfunction after liver transplantation
• Liver failure after liver surgery
• Secondary liver failure