Survival predictors in patients treated with a molecular adsorbent recirculating system

Table 1 Indications for MARS and treatment protocols

Etiology	MARS treatment initiation criteria	Treatment protocol
ALF	Rapid deterioration of hepatic synthetic function and clinical condition despite standard medical therapy and (one of the following criteria)	Twenty-two hours sessions daily until the native liver recovers
	Ingestion of a lethal dose of a known hepatotoxin (mushroom, paracetamol, iron, etc)	A suitable transplant organ is found
	Patient fulfills the criteria for highly urgent Ltx	Irreversible organ damage occurs
AOCLF	Rapid deterioration of hepatic synthetic function and clinical condition despite standard medical therapy and (two of the following criteria)	Eight hours sessions based on the daily assessment of the surgeon and anesthesiologist until the patient’s clinical condition improves
	Hyperbilirubinemia, bil > 400 &mgr;mol/L	A suitable transplant organ is found
	Hepatorenal syndrome type 1	Irreversible organ damage occurs
	Progressive hepatic encephalopathy (grade ≥ 2)
GF	No set criteria; depends on the assessment of the transplant surgeon and anesthesiologist	No set protocol; based on the daily assessment of the surgeon and anesthesiologist

ALF: Acute liver failure; AOCLF: Acute-on-chronic liver failure; GF: Graft failure.