G. Novelli 1 , M. Rossi 1 , V. Morabito 1 , F. Pugliese 1 , P. Berloco 1 1 La Sapienza University, Rome, Italy Background: Hepatitis B (HBV)-related end-stage liver disease is one of the most common indication for liver transplantation (LT). A number of patients dying while on the waiting list or removed because of being too ill is progressively increasing. We valued the possibility to improve the Model End-stage Liver Disease (MELD) of patients awaiting liver transplantation using a albumin dialysis: Molecular Adsorbent Recirculating System (MARS). Methods: We treated 34 patients (19 male and 15 female) with a mean age 49.5. Inclusion criteria: serum bilirubine > 15mg/dl, MELD 25, INR > 2.1, Encephalopathy Grade II. All patients were treated with MARS mean 9±2.5 hr cycles and mean 9 treatments (range 3-15). All patients received standard medical treatment in addition to MARS dialysis. The patient survival was valued at six months. Results: We obtained a significant change of cytokines levels as Interlukine 6 (p< 0.02) and Tumor Necrosis Factor alfa (p<0.01) in association with an improvement of kidney, hepatic and hemodynamic parameters. At the end of MARS treatments we observed a significant reduction of MELD score (p<0.003). The results of MELD show a rebound effect between the end of treatment and the follow up at six months without returning at starting values (p<0.005). Twenty patients lived and 14 dead for clinical complications. Conclusion: The improved MELD score with MARS gave patients on LT waiting list more time of survival, thus allowing them more opportunity for liver transplantation.