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Ram Subramanian, MD, Says There is Hope for Acute Liver Failure Patients

For patients in acute liver failure, time is precious. In many cases, a patient’s only hope is a liver transplant, but the wait for a viable — and matching — organ can be too long.

The Emory Transplant Center now offers Molecular Adsorbents Recirculating System (MARS), a liver dialysis system approved by the U.S. Food and Drug Administration (FDA) to treat select patients with acute liver failure due to drugs or toxins. Acute liver failure often results from drug overdose or idiosyncratic medication reactions. The most common cause of acute liver failure is acetaminophen overdose.

“We have long had kidney dialysis to stabilize patients in renal failure, but until now, we have not had a corresponding method of treatment for patients in acute liver failure,” says transplant hepatologist and intensivist Ram Subramanian, MD, assistant professor at Emory University School of Medicine. “ MARS is a potential game changer for patients who either don’t qualify for transplant or who don’t have the time that is critical to wait for a transplant.”

Patients in acute liver failure are unable to clear certain toxins from their systems, so the MARS system does the work for them by drawing blood from patients and cleansing it with solution containing albumin. Albumin is produced by healthy livers and binds to certain medications and other bodily substances to transports them throughout the body. It also binds toxins, protecting the body from their toxic effects. The cleansed blood is returned to the patient’s circulatory system to attract more toxins.

While MARS currently is FDA approved only for treatment of acute liver failure, MARS has been used successfully in clinical trials to treat forms of chronic liver illness.

“Several studies in Europe have demonstrated that MARS is effective in treating chronic liver failure as well,” says Subramanian. “My hope is that it becomes another tool for us in offering hope to patients who are dealing with all kinds of liver failure.”

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