Molecular Adsorbent Recirculating System (MARS®) is a non-biological artificial liver device. The benefit risk ratio between uncertain clinical effects and potential adverse events remains difficult to assess. We sought to describe adverse events related to MARS® therapy as well as biological and clinical effects. All intensive care unit (ICU) admissions to whom MARS® therapy was prescribed from March 2005 to August 2021 were consecutively and prospectively included. The main endpoint was the incidence of adverse events related to MARS® therapy. Secondary endpoints were the biological and clinical effects of MARS® therapy. We reported 180 admissions treated with MARS® therapy. Among the 180 admissions, 56 (31.1%) were for acute-on-chronic liver failure, 32 (17.8%) for acute liver failure, 28 (15.5%) for post-surgery liver failure, 52 (28.9%) for pruritus and 12 (6.7%) for drug intoxication. At least one adverse event occurred in 95 (52.8%) admissions. Thrombocytopenia was the most frequent adverse event which was recorded in 55 admissions (30.6%). Overall, platelets count was 131 (± 95) × 109/L before and 106 (± 72) × 109/L after MARS® therapy (p < .001). After MARS® therapy, total bilirubin was significantly decreased in all groups (p < 0.05). Hepatic encephalopathy significantly improved in both the acute-on-chronic and in the acute liver failure group (p = 0.01). In the pruritus group, pruritus intensity score was significantly decreased after MARS® therapy (p < 0.01). In this large cohort of patients treated with MARS® therapy we report frequent adverse events. Thrombocytopenia was the most frequent adverse event. In all applications significant clinical and biological improvements were shown with MARS® therapy.

中文翻译：

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重症监护病房中体外肝治疗的不良事件、短期和长期结果：在单一中心使用 MARS® 的 16 年经验

分子吸附再循环系统 (MARS®) 是一种非生物人工肝装置。不确定的临床效果和潜在不良事件之间的获益风险比仍然难以评估。我们试图描述与 MARS® 治疗相关的不良事件以及生物学和临床效应。所有在 2005 年 3 月至 2021 年 8 月期间接受 MARS® 治疗的重症监护病房 (ICU) 入院患者均被连续前瞻性纳入。主要终点是与 MARS® 治疗相关的不良事件的发生率。次要终点是 MARS® 疗法的生物学和临床效果。我们报告了 180 例接受 MARS® 治疗的入院患者。180例入院患者中，慢加急性肝衰竭56例（31.1%），急性肝衰竭32例（17.8%），术后肝衰竭28例（15.5%），52例（28. 9%) 用于瘙痒，12 (6.7%) 用于药物中毒。95 例 (52.8%) 入院患者中至少发生了 1 次不良事件。血小板减少症是最常见的不良事件，记录在 55 例入院 (30.6%) 中。总体而言，血小板计数在 MARS® 治疗前为 131 (± 95) × 109/L，在 MARS® 治疗后为 106 (± 72) × 109/L (p < .001)。MARS® 治疗后，所有组的总胆红素均显着降低（p < 0.05）。慢加急性组和急性肝衰竭组的肝性脑病显着改善（p = 0.01）。在瘙痒组中，MARS® 治疗后瘙痒强度评分显着降低（p < 0.01）。在这个接受 MARS® 治疗的大型患者队列中，我们报告了频繁的不良事件。血小板减少症是最常见的不良事件。