UChicago Medicine is one of the first hospitals in Illinois to offer MARS therapy for patients with acute liver failure

For patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF), the toxins that build up in their blood can cause confusion, tremors, vomiting, abdominal pain and stomach swelling.

Having a liver unable to clean the body’s blood is a life-threatening condition, and patients are told to seek immediate medical assistance.

The sickest of these patients can die within days without a new liver. Lifesaving mechanical support treatments routinely extend the lives of heart, lung and kidney failure patients, but haven't been an option for liver failure.

Now, doctors at the University of Chicago Medicine have a new treatment to help: Molecular Adsorbent Recirculating System (MARS) therapyRolf Barth, MDTransplant InstituteJay Koyner, MD, Medical Director and Acute Dialysis Director of the ICU Nephrology program. “It does, however, supplement the work of the liver to avoid further toxin buildup and to remove toxins that have already accumulated."

MARS can serve as a bridge so that the patient's liver and kidney laboratory results improve and, with time, normal metabolism can occur, he said. "This buys precious time for a patient's liver to get better," Koyner said.

MARS is the only FDA-approved mechanical device for the treatment of acute liver failure. It is FDA-approved for treating acute liver failure due to drug overdoses and poisoning (the most common being acetaminophen (Tylenol) overdose), as well as liver-related encephalopathy, a condition that can cause serious neurological problems.

Along with other UChicago Medicine colleagues, Barth has also researched the use of MARS for severe liver trauma and as a bridge to transplantation during sudden, unexpected liver failure.

Transplant hepatologist Anjana Pillai, MD, said MARS therapy could be helpful when treating some of UChicago Medicine’s sickest patients. About 30% of UChicago Medicine liver transplant recipients are in the intensive care unit prior to their transplant surgery, compared to 20% nationally.

“Due to our program’s reputation for taking on the sickest cases when it comes to liver transplantation, we are often the referral center for many second and third opinions throughout the state and nationally,” said Pillai, Medical Director of the Liver Tumor Program and Adult Living Donor Liver Transplant Program