Molecular adsorbent recycling system (MARS): Clinical results of a new membrane-based blood purification system for bioartificial liver support

The use of xenogenic or genetically engineered cell types in bioartificial liver support systems requires separation methods between the patients' blo od and the liver support bioreactors that guarantee the sufficient transfer of pathophysiologically relevant substances but prevent complications. The present paper describes a new membrane separation system that is nearly im permeable to proteins but enables the exchange of water soluble and protein bound toxins by a special membrane and a recycled protein containing dialy sate. Because the full range of toxins in hepatic failure has still not bee n identified, the value of this membrane separation method was evaluated cl inically. Thirteen patients suffering from life threatening hepatic failure who had not responded to state of the art therapy were treated with this d evice, the molecular adsorbent recycling system (MARS). The overall surviva l rate was 69%. All patients showed positive response to the therapy, indic ating that the presented membrane separator combines therapeutic effectivit y with the highest safety criteria for the patient by cutting the exchange of substances below the level of proteins.