5PSQ-007 Molecular adsorbent recirculating system (MARS) in a critical care unit for hepatic failure

<h3>Background and Importance</h3> Hepatic failure is a condition with challenging management, which is further complicated upon hospital admission. One of the techniques used to alleviate the complications of these pathologies is the so-called ‘Molecular Adsorbent Recirculating System’ (MARS), which is an extrahepatic detoxification system that uses albumin to purify toxins that the liver is not able to eliminate. <h3>Aim and Objectives</h3> The objective of this study was to evaluate the efficacy of this technique used in critical care units to primarily treat hepatic encephalopathy (HE), hyperbilirubinaemia and as supportive therapy until liver transplantation. <h3>Material and Methods</h3> We conducted a descriptive, observational, and retrospective study (2013 to 2023) of patients treated with MARS technique in a tertiary hospital. The data were obtained from the electronic medical records of the patients. The parameters analysed were: demographic information, underlying liver disease, indication for MARS technique, number of sessions, bilirubin level or HE grade before and after the procedure, whether they received a liver transplant afterwards, and whether they were exitus. <h3>Results</h3> Twenty-five patients received MARS treatment, including 16 (64%) men with a mean age of 52 (range 16–72) years. The underlying liver disease: 11 (44%) with alcoholic cirrhosis, six (24%) transplant rejection four (16%), and other condition four (16%). Ten (40%) patients had portal hypertension and 10 (40%) had oesophageal varices. The indications for MARS were: 12 (44%) for hyperbilirubinemia, five (20%) for encephalopathy, five (20%) for acute liver failure and three (12%) for transplant rejection. Patients with HE: one improved while four (80%) remained the same or worsened and they ended up being exitus. Patients with hyperbilirubinemia: eight (66%) improved bilirubin levels. Seven (58%) were exitus. The relative bilirubin decreases were similar in those who survived and those who died (21.17% vs 22.76%). The five patients with acute liver failure managed to be transplanted, although two died. There were nine (36%) patients who received a liver transplant, and exitus was 14 (56%). <h3>Conclusion and Relevance</h3> In our sample of patients, it has not been able to reduce mortality or improve the underlying complications of this pathology. The patients who used it as a bridge therapy for transplantation were successful, but their success cannot be affirmed thanks to the technique due to the doubtful results in the rest of the patients. <h3>References and/or Acknowledgements</h3> DOI: 10.1002/hep.21930 <h3>Conflict of Interest</h3> No conflict of interest