Artificial liver support systems: what is new over the last decade?

García Martínez, Juan José; Bendjelid, Karim

doi:10.1186/s13613-018-0453-z

Annals of Intensive Care

Table 1 Studies with clinical endpoints for ALF using MARS

From: Artificial liver support systems: what is new over the last decade?

Study	Years	Design	Patients number	Outcomes	Comments	LOE
Kantola et al. [35]	2008	Controlled, non-randomized MARS + SMT vs. SMT	159	No improvement in 28-day and 6-month survivals	Trend to improved survival in unknown aetiology subgroup Likely improvement in HE	2
Novelli et al. [45]	2008	Uncontrolled, prospective	6	Neurological and haemodynamic improvements*	Paediatric population	3
					PELD and SOFA improvement**
Novelli et al. [46]	2009	Uncontrolled, retrospective	45	Number of MARS treatments associated with survival*	No improvement with MARS is a predictive factor of a fatal outcome and the need for a transplant	3
Camus et al. [47]	2009	Uncontrolled, retrospective	18	Clinical improvement	Clinical improvement compared to a control group obtained from a national register*	3
				MARS therapy associated with withdrawal from the emergency transplantation list*
Saliba et al. [33]	2013	Controlled, randomized, multicentre MARS + SMT vs. SMT	102	No improvement in 6-month, 6-month transplantation-free and 1-year survivals	High transplant rate and short waiting time until transplant	1
					Similar adverse effects
Lexmond et al. [36]	2015	Controlled, non-randomized MARS + SMT vs. SMT	20	No improvement in survival	Patients in MARS group were sicker	2
					Patients in MARS group received more thrombocyte transfusion*
					Paediatric population
Gerth et al. [37]	2017	Controlled, non-randomized MARS + SMT vs. SMT	73	No improvement in 28-day survival	Patients with graft dysfunction included	2
					No differences in outcomes between subgroups
					Biochemical improvement**
Hanish et al. [48]	2017	Uncontrolled, retrospective	27	Improvement in encephalopathy and in the APACHE II score**	Biochemical improvement*	3
Quintero Bernabeu et al. [49]	2018	Uncontrolled, retrospective	11	Haemodynamic improvement*	Paediatric population	3
					No significant adverse effects

LOE level of evidence, determined using the strength of recommendation taxonomy (SORT) criteria [50], SMT standard medical therapy, HE hepatic encephalopathy, PELD paediatric end-stage liver disease, SOFA sequential organ failure assessment, APACHE II Acute Physiology and Chronic Health Evaluation II
*p < 0.01
**p < 0.05

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