scholarly journals Molecular adsorbent recirculating system for acute and acute-on-chronic liver failure: A meta-analysis

2004 ◽  
Vol 10 (9) ◽  
pp. 1099-1106 ◽  
Author(s):  
Mohammed S. Khuroo ◽  
Mehnaaz S. Khuroo ◽  
Karim L.C. Farahat
Keyword(s):  
Liver Failure ◽  
Meta Analysis ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Molecular Adsorbent Recirculating System ◽  
Molecular Adsorbent

scholarly journals Meta-analysis of individual patient data of albumin dialysis in acute-on-chronic liver failure: focus on treatment intensity

2019 ◽  
Vol 12 ◽  
pp. 175628481987956 ◽  
Author(s):  
Rafael Bañares ◽  
Luis Ibáñez-Samaniego ◽  
Josep María Torner ◽  
Marco Pavesi ◽  
Carmen Olmedo ◽  
...  
Keyword(s):  
Liver Failure ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Chronic Liver ◽  
Treatment Intensity ◽  
Chronic Liver Failure ◽  
Albumin Dialysis ◽  
Liver Support ◽  
Molecular Adsorbent Recirculating System

Background: Acute-on-chronic liver failure (ACLF) is a common complication of cirrhosis characterized by single or multiple organ failures and high short-term mortality. Treatment of ACLF consists of standard medical care (SMC) and organ(s) support. Whether the efficacy of artificial liver support (ALS) depends on the severity of ACLF or on the intensity of this treatment, or both, is unclear. This study aimed to further assess these issues. Methods: We performed an individual patient data meta-analysis assessing the efficacy of Molecular Adsorbent Recirculating System (MARS) in ACLF patients enrolled in prior randomized control trials (RCTs). The meta-analysis was designed to assess the effect of patient severity (ACLF grade) and treatment intensity [low-intensity therapy (LIT), SMC alone or SMC plus ⩽ 4 MARS sessions, high-intensity therapy (HIT), SMC plus > 4 MARS sessions] on mortality. Results: Three RCTs suitable for the meta-analysis ( n = 285, ACLF patients = 165) were identified in a systematic review. SMC plus MARS (irrespective of the number of sessions) did not improve survival compared with SMC alone, neither in the complete population nor in the ACLF patients. Survival, however, was significantly improved in the subgroup of patients receiving HIT both in the entire cohort (10-day survival: 98.6% versus 82.8%, p = 0.001; 30-day survival: 73.9% versus 64.3%, p = 0.032) and within the ACLF patients (10-day survival: 97.8% versus 78.6%, p = 0.001; 30-day survival: 73.3% versus 58.5%, p = 0.041). Remarkably, HIT increased survival independently of ACLF grade. Independent predictors of survival were age, Model for End-Stage Liver Disease (MELD), ACLF grade, number of MARS sessions received, and intensity of MARS therapy. Conclusion: HIT with albumin dialysis may improve survival in patients with ACLF. Appropriate treatment schedules should be determined in future clinical trials.

Impact of molecular adsorbent recirculating system on renal recovery in type-1 hepatorenal syndrome patients with chronic liver failure

2013 ◽  
Vol 28 (6) ◽  
pp. 1019-1024 ◽  
Author(s):  
Laurence Lavayssière ◽  
Siba Kallab ◽  
Isabelle Cardeau-Desangles ◽  
Marie Béatrice Nogier ◽  
Olivier Cointault ◽  
...  
Keyword(s):  
Liver Failure ◽  
Hepatorenal Syndrome ◽  
Chronic Liver ◽  
Renal Recovery ◽  
Chronic Liver Failure ◽  
Molecular Adsorbent Recirculating System ◽  
Type 1 Hepatorenal Syndrome ◽  
Molecular Adsorbent

scholarly journals Probit-analysis for assessing the effectiveness of various treatment methods for chronic liver failure

2014 ◽  
Vol 95 (3) ◽  
pp. 348-351
Author(s):  
D E Kutepov
Keyword(s):  
Liver Failure ◽  
Plasma Exchange ◽  
Conventional Treatment ◽  
High Volume ◽  
Probit Analysis ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Treatment Methods ◽  
Molecular Adsorbent Recirculating System ◽  
Molecular Adsorbent

Aim. To estimate the validity of probit-analysis for assessing the effectiveness of various treatment methods for chronic liver failure. Methods. The study included 292 patients with chronic liver failure. All patients were distributed to four groups, conventional treatment was performed in all patients. Patients of the 2nd group were additionally administered plasma exchange, of the 3rd group - plasma exchange and high volume continuous veno-venous hemofiltration, of the 4th - molecular adsorbent recirculating system (MARS). To determine the medium lethal time (time at which 50% of patients pass away, ТL50), probit-analysis based on studying the association between the time logarithms and probits corresponding to the observed effects, was used. Results. Standardization of patients’ mortality rate, allowing to exclude biases associated with differences of chronic liver failure severity at admission, was performed. Probit-analysis showed that there were no significant differences in between male and female patients regardless of used treatment methods. ТL50 in patients of any gender treated only by conventional methods was significantly lower compared to other methods of treatment. There was a trend of ТL50 increase in the following sequence: conventional treatment → plasma exchange → plasma exchange and high volume continuous veno-venous hemofiltration → molecular adsorbent recirculating system. Conclusion. Probit-analysis allows to determine the time of 50% mortality (ТL50) in patients with chronic liver failure. Treatment using extracorporeal methods of treatment (plasma exchange, plasma exchange and high volume continuous veno-venous hemofiltration, molecular adsorbent recirculating system) is significantly more effective compared to conventional treatment.

scholarly journals Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: The RELIEF trial

Hepatology ◽  
2013 ◽  
Vol 57 (3) ◽  
pp. 1153-1162 ◽  
Author(s):  
Rafael Bañares ◽  
Frederik Nevens ◽  
Fin Stolze Larsen ◽  
Rajiv Jalan ◽  
Agustín Albillos ◽  
...  
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Albumin Dialysis ◽  
Molecular Adsorbent Recirculating System ◽  
Molecular Adsorbent
Sign in / Sign up

Export Citation Format

Share Document