Kramer et al.29
|
2000 |
20 patients with cirrhosis who developed HE (ACLF); median age: 56 years, range: 33–71 years, 13 men |
BioLogic-DT (n = 10) |
Decreased platelet count (from 75 to 26 g/L; p = 0.01) and fibrinogen (from 185 to 106 mg/dL; p < 0.001) level
Increased INR (from 2.0 to 2.2; p < 0.001)
Decreased creatinine (from 1.0 to 0.9; p = 0.007) and BUN (from 28 to 25; p = 0.01)
No change in albumin, bilirubin, AST, ALT or ammonia
|
Kramer et al.30
|
2002 |
8 cirrhotic patients with hepatorenal syndrome; etiologies: -alcoholic (6) -Hepatitis C (1) -Cryptogenic (1) |
Prometheus (n = 8) |
Significant decreases in bilirubin (p = 0.002), BUN (p = 0.02) and creatinine (p < 0.001) from baseline
No incidences of bleeding or hemodynamic instability observed
|
Stadlbauer et al.31
|
2006 |
8 patients with ACLF: -alcoholic cirrhosis (4) -Chronic HCV (1) -Metastatic colon cancer (1) -Liver graft dysfunction (1) |
MARS and Prometheus, cross-over (n = 8) |
No significant changes in serum levels of any cytokine were found after treatments with MARS or Prometheus
In MARS treatments, IL-10 was cleared from plasma more efficiently than IL-6
Clearance of IL-10 was higher in Prometheus than in MARS treatments.
|
Stadlbauer et al.32
|
2007 |
8 patients with ACLF: -alcoholic cirrhosis (4) -Chronic HCV (1) -Metastatic colon cancer (1) -Liver graft dysfunction (1) |
MARS and Prometheus, cross-over (n = 8) |
Total and individual bile acids were removed efficiently by both systems
With both devices, absolute reduction of chenodeoxycholic acid (CDCA) was higher than that of cholic acid (CA)
Reduction ratios were significantly higher for CA than for CDCA in Prometheus, no difference with MARS
|
Klammt et al.33
|
2008 |
24 patients with ACLF |
MARS (n = 12) |
|
Dethloff et al.34
|
2008 |
24 patients under evaluation for liver transplant: -Alcoholic cirrhosis (15) -Hepatitis C (2) -Autoimmune (2) -PBC, porthyria, cholesterol storage disorder, hemochromartosis, unknown (1 each) |
Prometheus (n = 8) MARS (n = 8) Hemodialysis (control, n = 8) |
Increase in arterial pressure in the MARS group (P = 0.008)
Significant decrease in creatinine levels in the MARS (P = 0.03) and hemodialysis (P = 0.04)groups
Decreased platelet count in the Prometheus group (P = 0.04)
|
Iarustovski et al.35
|
2014 |
26 patients with ALF and MODS as postoperative complications after cardiac surgery |
MARS (n = 9) Prometheus (n = 17) |
|
Klammt et al.36
|
2014 |
24 patients with a decompensation of a pre-existing cirrhosis (ACLF) with severe hyperbilirubinemia (total serum bilirubin >20 mg/dL) |
MARS (n = 12) |
11 out of 12 patients (91.7%) in the MARS group survived the study period; 6/12 patients (50%) in the control group died
No relationship was found between the decline of platelet count and the number of consecutive treatments
|
Sponholz et al.37
|
2016 |
32 patients with ALF, ACLF and graft failure |
MARS and SPAD |
Plasma bilirubin levels were significantly reduced by both systems (MARS: median −68 μmol/L, p = 0.001; SPAD: −59 μmol/L, p = 0.001)
Only MARS significantly reduced bile salts (−39 μmol/L, p < 0.001), creatinine (−24 μmol/L, p < 0.001) and urea (−0.9 mmol/L, p = 0.024)
Albumin-binding capacity was increased by MARS (+10%, p < 0.001)
|