One year experience with MARS-Therapy in patients with multiple organ failure in Cardiac Center Bad Oeynhausen

Patients with severe cardiac failure who need transplantation or implantation of ventricular assist-device as a bridging to cardiac transplantation can develop multiple organ failure, if such treatment can not be initiated immediately. Moreover, multiple organ failure can also occur in patients with septicemia after open heart surgery.

Since 1999 more than 4000 open heart surgery were performed in our Cardiac Center. In total of 7 patients with multiple organ failure (5 due to severe cardiac failure, 2 due to septicemia) were additionally treated with artificial liver support system called Molecular Absorbents Recirculation System (MARS) (MARS-device was kindly provided by Teraklin Company, Rostock, Germany).

During and after MARS-Therapy (duration of treatment were approximately 48 to 72 hrs), in almost all patients, the serum bilirubin was reduced or at least not further increased. The neurological symptomatic (based on Glasgow coma scale) were improved. However the liver transaminase seems to remain high. The interpretation of thromboplastin time, and cholinesterase was difficult due to substitution of fresh frozen plasma in those patients.

One patient got cardiac transplantation, one patient still has retractable septicemia, one patient died through septicemia, one patient died through lung injury after being discharged from our clinic, one patient died due to gastrointestinal bleeding caused by ischemic colitis, and the remaining 2 patients are still waiting for cardiac transplantation.

Definitive conclusion for the effectiveness of MARS-Therapy in patients with multiple organ failure can not be drown at this moment due to limited number of treated patients. Further clinical studies have to follow.