Dissertation
Dissertation > Medicine, health > Surgery > Of surgery > Abdominal surgery > Liver and liver tube

The Study of Molecular Adsorbent Recycling System (MARS) Treatment in the Perioperative Period of the Orthotopic Liver Transplantation

Author Manal Abdulrazig Mukhtar
Tutor HuangZuFa;YeQiFa
School Central South University
Course Surgery
Keywords MARS Liver transplantation Preoperative support Intraoperative support Intraoperative transit flow Early postoperative Delayed recovery of liver function Supportive care Long-term postoperative Transplantation of chronic liver dysfunction
CLC R657.3
Type PhD thesis
Year 2006
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PartⅠThe Clinical Study of Molecular Adsorbent Recycling System(MARS)in Preoperative Period of Orthotopic Liver Transplantation(OLT)Objectives: To summerize the experiences of molecular adsorbent recycling system(MARS) in perioperative period with orthotopic liver transplantation(OLT). Methods: To follow up and review the effects of MARS artificial liver treatments in 15 cases. Results: The levels of serum total bilirubin, BUN, Creatinine, uric acid and blood ammonia were greatly reduced by MARS. 14 patients were bridged to transplantation, 1 patient with hepatic encephalopathy was relieved after MARS treatment, died 3 days after discharged from hospital.Conclusion: MARS artificial liver is a safe and effective supportive device. It can help patients to gain more chance of undergoing OLT.PartⅡThe Clinical Study of Molecular Adsorbent Recycling System(MARS) in Intraoperative Period of Orthotopic Liver Transplantation(OLT)Purposes: To study the clinical value of MARS in the intraoperative period of PBLT assisted with simplified venous-venous bypass. Methods: In the treatment group, MARS was applied in 86 patients in the intraoperative phase of PBLT assisted with simplified venous-venous bypass. In the control group, PBLTs were performed traditionally in 60 patients without venous-venous bypass. The related parameters of the two groups were compared. Results: The time length of operation, anhepatic phase, the amount of blood transfusion, the time length of stay in ICU, the 1 month survival rate, the 1 year survival rate in the treatment group were significantly better than the control group.Conclusions: MARS applied in the intraoperative phase of PBLT assisted with simplified venous-venous bypass can improve the prognosis of the OLT.PartⅢThe Clinical Study of Molecular Adsorbent Recycling System(MARS) in early Postoperative Period of Orthotopic Liver Transplantation(OLT)Objectives: To summerize the experiences of molecular adsorbent recycling system(MARS) support in early postoperative period of orthotopic liver transplantation(OLT). Methods: To review the effects of MARS artificial liver treatments retrospectively in 5 patients with delayed graft function in early postoperative period. Results: The levels of serum total bilirubin, BUN, Creatinine, uric acid and blood ammonia were greatly reduced by MARS. 4 patients were recovered, 1 patient with severe ischemia reperfusion injury was relieved after MARS treatment, died 2 weeks after discharged from hospital because of refusal of retransplantation.Conclusion: MARS artificial liver is a safe and effective supportive device. It can help patients with delayed graft function in early postoperative period to pass the critical time.PartⅣThe Clinical Study of Molecular Adsorbent Recycling System(MARS) in the Long-term Survival in Postoperative Period of Orthotopic Liver Transplantation(OLT) Objectives: To study molecular adsorbent recycling system(MARS) liver support for the patients with chronic graft failure in lomg-term postoperative period of orthotopic liver transplantation(OLT). Methods: To review the effects of MARS liver support in 10 patients with graft failure who survived more than 3 years posttransplantation. Results: 9 patients with chronic graft failure recovered and discharged from hospital after 3 episodes of MARS liver support, 1 patient was relieved by both MARS treatment and plasma exchange.Conclusion: MARS liver support is a safe and effective supportive therapy for the patients with chronic graft failure in long-term postoperative period. It can help patients to pass the critical phase of graft failure for the long term postoperative period of orthotopic liver transplantation(OLT).

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