The term “Mars liver” refers to the Molecular Adsorbent Recirculating System (MARS), a specialized medical technology. This system functions as an artificial liver support, designed to help the body manage the severe consequences of liver failure. It serves as a temporary measure, assisting the body in detoxifying the blood when the liver is unable to perform this function effectively. MARS aims to support patients while their own liver recovers or until a liver transplant can be performed.
Understanding How MARS Works
The MARS system operates on the principle of albumin dialysis, a process that removes toxins from the blood. The patient’s blood is first passed through a specialized filter containing a semipermeable membrane. On the other side of this membrane, a solution enriched with human albumin circulates, acting like a sponge to draw out toxins from the blood.
This albumin-rich solution then flows through a series of adsorbers to remove the accumulated toxins. An activated charcoal adsorber binds and removes harmful substances, including protein-bound toxins like bilirubin and bile acids. Following this, an anion exchange resin purifies the albumin by removing negatively charged toxins. This regeneration process allows the albumin solution to be continuously recycled, maintaining its ability to extract toxins from the patient’s blood.
When MARS is Utilized
MARS therapy is used when the liver’s function is severely impaired. It is used for patients experiencing acute liver failure, a sudden and severe loss of liver function. It also treats acute-on-chronic liver failure, where individuals with pre-existing liver disease experience a sudden worsening of their condition.
The system also supports severe drug-induced liver injury, where medications have caused significant liver damage. In these instances, MARS can serve as a “bridge to transplant,” providing temporary liver support while a suitable donor organ becomes available. Alternatively, it allows time for the patient’s own liver to regenerate and recover.
The Role of MARS in Liver Support
MARS therapy provides extracorporeal liver support, complementing the impaired liver’s detoxification functions. It achieves this by removing toxins from the bloodstream, including water-soluble and protein-bound substances. This detoxification helps stabilize the patient’s condition by reducing the toxic burden.
MARS therapy also improves brain function in patients with hepatic encephalopathy, a neurological complication of severe liver disease. By removing neurotoxins that accumulate in liver failure, it alleviates symptoms such as confusion and altered consciousness. The treatment also maintains stable blood pressure and circulation.
Considerations for MARS Therapy
Patient selection is crucial for MARS therapy. Candidates have acute liver failure or acute exacerbations of chronic liver disease, often with hepatic encephalopathy or hemodynamic instability. The treatment requires a specialized medical team and is administered within an intensive care unit due to close monitoring.
A MARS session can last for several hours, and the treatment duration varies depending on the patient’s condition and response to therapy, often involving multiple sessions. While generally well-tolerated, potential side effects can include fluid shifts or electrolyte imbalances, necessitating careful monitoring and management. MARS is a supportive therapy, designed to assist the body and gain time, rather than a curative treatment for the underlying liver disease.