123 CASES OF ALF TREATED WITH MARS

Liver Support Devices to improve clinical condition before LT in 14 patients with PNF, 26 by fulminant hepatitis, 17 were affected by delayed non function, 60 by acute on chronic hepatic failure. The average age of patients was 41.8 yrs, and the average number of application of MARS was 6 (range: 1–24), the mean length of application instead was about 9 h (range: 8–20). In AoCHF patients 6 to 11 hours treatments were carried out (average 8.5) for a minimum of 3 treatments. The majority of patients were treated in ICU. Laboratory results were monitored and showed progressive modification: bilirubine (pre-treatment 22.37±11.6 mg/dl, after treatment 11.36±7.5 mg/dl) ammonium (pre-treatment 238.2±19μg/dl, after treatment 115.4±12 μg/dl) showed significant change (p<0.01). Lactates (pre-treatment 3.48±1.3 mmol/L, after treatment 1.76±1.1 mmol/L) and creatinine (pre-treatment 2.36±0.18 mg/dl, after treatment 1.26±0.67 mg/dl) also showed significant change (p<0.02 and p<0.04). GCS went from 8.6±1.4 to 11.9±3.9 (p<0.05). A mean middle celebral artery flow went from 46 cm/sec (26–59) to 73 cm/sec (52–106) showing a decrease in celebral edema. INR scores (before treatment 2.4 after treatment 1.8) also showed no significant change. The MARS can be applied with tolerability for long period. It can be used in patients with DNF and FH as a bridge to transplant. In patients with DF it’s used for waiting to complete recovery of the transplanted organ.