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Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial

Open access
Mitzner, Steffen R., Stange, Jan, Klammt, Sebastian, Risler, Teut, Erley, Christiane M., Bader, Brigitte D., Berger, Elke D., Lauchart, Werner, Peszynski, Piotr, Freytag, Jens, Hickstein, Heiko, Loock, Jan, Löhr, Johannes-Mathias, Liebe, Stefan, Emmrich, Jörg, Korten, Gero, Schmidt, Reinhard·2000·Liver Transplantation
DOI 10.1002/lt.500060326
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Abstract

In hepatorenal syndrome (HRS), renal insufficiency is often progressive, and the prognosis is extremely poor under standard medical therapy. The molecular adsorbent recirculating system (MARS) is a modified dialysis method using an albumin-containing dialysate that is recirculated and perfused online through charcoal and anion-exchanger columns. MARS enables the selective removal of albumin-bound substances. A prospective controlled trial was performed to determine the effect of MARS treatment on 30-day survival in patients with type I HRS at high risk (bilirubin level, ≥15 mg/dL) compared with standard treatment. Thirteen patients with cirrhosis with type I HRS were included from 1997 to 1999. All were Child’s class C, with Child-Turcotte-Pugh scores of 12.4 ± 1.0, United Network for Organ Sharing status 2A, and total bilirubin values of 25.7 ± 14.0 mg/dL. Eight patients were treated with the MARS method in addition to hemodiafiltration (HDF) and standard medical therapy, and 5 patients were in the control group (HDF and standard medical treatment alone). None of these patients underwent liver transplantation or received a transjugular intrahepatic portosystemic shunt or vasopressin analogues during the observation period. In the MARS group, 5.2 ± 3.6 treatments (range, 1 to 10 treatments) were performed for 6 to 8 hours daily per patient. A significant decrease in bilirubin and creatinine levels (P< .01) and increase in serum sodium level and prothrombin activity (P< .01) were observed in the MARS group. Mortality rates were 100% in the control group at day 7 and 62.5% in the MARS group at day 7 and 75% at day 30, respectively (P< .01). We conclude that the removal of albumin-bound substances with the MARS method can contribute to the treatment of type I HRS.

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Research works printed but not linked: 37

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Metadata

Authors
Mitzner, S. R., Stange, J., Klammt, S., Risler, T., Erley, C. M., Bader, B. D., Berger, E. D., Lauchart, W., Peszynski, P., Freytag, J., Hickstein, H., Loock, J., Löhr, J.-M., Liebe, S., Emmrich, J., Korten, G., & Schmidt, R.
Venue
Liver Transplantation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2000-05
Volume
6
Issue
3
Pages
277-286
ISSN
1527-6465 (ISSN-L)
DOI
10.1002/lt.500060326
OpenAlex
W2073024831
Cited by
717
References
1
FWCI
28.49
Type
journal article
Language
en
Open access
bronze
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 5601 d)

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CoChat. (2026). Citation check: Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial. https://app.cochat.ai/papers/10.1002/lt.500060326
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Mitzner, S. R., Stange, J., Klammt, S., Risler, T., Erley, C. M., Bader, B. D., Berger, E. D., Lauchart, W., Peszynski, P., Freytag, J., Hickstein, H., Loock, J., Löhr, J.-M., Liebe, S., Emmrich, J., Korten, G., & Schmidt, R. (2000). Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial. Liver Transplantation. https://doi.org/10.1002/lt.500060326

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.