page_title: Liver support system
section_title: MARS System Components
hierarchical_section_title: Liver support system / MARS System Components
caption_attribution_description: English: Combined MARS and PrismaFlex monitors
context_page_description: A liver support system is a therapeutic device to assist in performing the functions of the liver in persons with liver damage.
  The primary functions of the liver include removing toxic substances from the blood, manufacturing blood proteins, storing energy in the form of glycogen, and secreting bile. The hepatocytes that perform these tasks can be killed or impaired by disease, resulting in hepatic insufficiency. A sudden onset of life-threatening hepatic insufficiency is known as acute liver failure.
  In hyperacute and acute liver failure the clinical picture develops rapidly with progressive encephalopathy and multiorgan dysfunction such as hyperdynamic circulation, coagulopathy, acute kidney injury and respiratory insufficiency, severe metabolic alterations and cerebral edema that can lead to brain death. In these cases the mortality without liver transplantation ranges between 40-80%. LTx is the only effective treatment for these patients although it requires a precise indication and timing to achieve good results.
context_section_description: MARS is an extracorporeal hemodialysis system composed of three different circuits: blood, albumin and low-flux dialysis. The blood circuit uses a double lumen catheter and a conventional hemodialysis device to pump the patient's blood into the MARS FLUX, a biocompatible polysulfone high-flux dialyser. With a membrane surface area of 2.1 m², 100 nm of thickness and a cut-off of 50 KDa, the MARSFLUX is essential to retaining the albumin in the dialysate. Blood is dialysed against a human serum albumin (HSA) dialysate solution that allows blood detoxification of both water-soluble and protein-bound toxins, by means of the presence of albumin in the dialysate (albumin dialysis). The albumin dialysate is then regenerated in a close loop in the MARS circuit by passing through the fibres of the low-flux diaFLUX filter, to clear water-soluble toxins and provide electrolyte/acid-base balance, by a standard dialysis fluid. Next, the albumin dialysate passes through two different adsorption columns; protein-bound substances are removed by the diaMARS AC250, containing activated charcoal and anionic substances are removed by the diaMARS IE250, filled with cholestyramine, an anion-exchange resin. The albumin solution is then ready to initiate another detoxifying cycle of the patient's blood that can be sustained until both adsorption columns are saturated, eliminating the need to continuously infuse albumin into the system during treatment (Fig. 1).
caption: Combined MARS and PrismaFlex monitors
exif: {"Image ImageDescription": "", "Image Make": "Canon", "Image Model": "Canon PowerShot A3000 IS", "Image Orientation": "Horizontal (normal)", "Image XResolution": "72", "Image YResolution": "72", "Image ResolutionUnit": "Pixels/Inch", "Image Software": "QuickTime 7.6.6", "Image DateTime": "2011:11:24 13:13:13", "Image HostComputer": "Mac OS X 10.6.8", "Image YCbCrPositioning": "Co-sited", "Image ExifOffset": "302", "Thumbnail Compression": "JPEG (old-style)", "Thumbnail XResolution": "72", "Thumbnail YResolution": "72", "Thumbnail ResolutionUnit": "Pixels/Inch", "Thumbnail JPEGInterchangeFormat": "3432", "Thumbnail JPEGInterchangeFormatLength": "6890", "Thumbnail YCbCrPositioning": "Centered", "EXIF ExposureTime": "1/60", "EXIF FNumber": "27/10", "EXIF ISOSpeedRatings": "400", "EXIF ExifVersion": "0220", "EXIF DateTimeOriginal": "2011:10:03 12:07:27", "EXIF DateTimeDigitized": "2011:10:03 12:07:27", "EXIF ComponentsConfiguration": "YCbCr", "EXIF CompressedBitsPerPixel": "3", "EXIF ShutterSpeedValue": "189/32", "EXIF ApertureValue": "23/8", "EXIF ExposureBiasValue": "0", "EXIF MaxApertureValue": "23/8", "EXIF MeteringMode": "Pattern", "EXIF Flash": "Flash fired, compulsory flash mode, red-eye reduction mode", "EXIF FocalLength": "31/5", "EXIF FlashPixVersion": "0100", "EXIF ColorSpace": "sRGB", "EXIF ExifImageWidth": "2736", "EXIF ExifImageLength": "3648", "EXIF FocalPlaneXResolution": "2736000/181", "EXIF FocalPlaneYResolution": "3648000/241", "EXIF FocalPlaneResolutionUnit": "2", "EXIF SensingMethod": "One-chip color area", "EXIF FileSource": "Digital Camera"}