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Molecular adsorbents recirculating system (MARS) liver support therapy is the development of albumin dialysis. This study was to assess the successful application of MARS artificial liver support therapy as a bridge to re-transplantation in two cases of long anhepatic duration.MARS therapy was given after failure plasma-exchange (PE) treatment, which resulted in circulatory derangement and acute renal dysfunction in a 36-year-old male patient. Finally his uncontrolled anhepatic condition led to a successful re-transplantation. In another 48-year-old man who was diagnosed as having primary nonfunction (PNF) during the liver transplantation, 10-hour MARS treatment contributed to smooth bridging of his anhepatic phase.The two anhepatic patients were bridged for 26 and 17 hours respectively to re-transplantation with MARS therapy.Our experience proves that MARS artificial liver can be an effective support for long time bridging PNF until re-transplantation is available.

A 27-year-old woman in her 20th week of pregnancy was hospitalized because of food poisoning caused by Amanita phalloides.Previously extracorporeal purification treatments with 2 times of hemodialysis plus hemoperfusion and a high volume therapeutic plasma exchange (PE) in addition to intensive medication during the first 8 days failed to improve hepatic encephalopathy (HE) and liver function but developed deep coma with severe blood chemistry and signs of threatened abortion.Treatments with intermittent molecular adsorbent recirculating system (MARS) for 3 times resulted in an immediate improvement of liver function and clinical symptoms including HE and threatened abortion until her fully recovery. When the life-threatening maternal illness was cured gestation went on until premature birth at the 36th week of pregnancy, and the infant underwent an undisturbed development.MARS method appears to be an optimal therapy for patients with acute liver failure secondary to cytoxic mushroom poisoning during pregnancy.