Adverse events, short- and long-term outcomes of extra corporeal liver therapy in the intensive care unit: 16 years experience with MARS® in a single center - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Critical Care Année : 2022

Adverse events, short- and long-term outcomes of extra corporeal liver therapy in the intensive care unit: 16 years experience with MARS® in a single center

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Background 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. Methods 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. Results 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) × 10 9 /L before and 106 (± 72) × 10 9 /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). Conclusion 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.
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hal-03781728 , version 1 (20-09-2022)

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Clément Monet, Audrey de Jong, Yassir Aarab, Lauranne Piron, Albert Prades, et al.. Adverse events, short- and long-term outcomes of extra corporeal liver therapy in the intensive care unit: 16 years experience with MARS® in a single center. Critical Care, 2022, 26 (1), pp.282. ⟨10.1186/s13054-022-04165-z⟩. ⟨hal-03781728⟩
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