Artificial liver support. Literature review

We performed a systematic review to assess the efficacy and safety of extracorporeal albumin dialysis systems in patients with liver failure. After screening 436 references, 10 controlled trials were detected. The analyzed interventions were MARS, Prometheus and Biologic-DT. Efficacy was proven by a reduction in bilirubin, creatinine and other toxic components after intervention. Clinical efficacy was measured in fewer studies, some of them showing an improvement in hepatic encephalopathy and survival. Intervention safety was assessed in a reduced number of studies and based on adverse events, being coagulation disorders in most cases. In summary, reviewed evidence showed that albumin dialysis based systems were able to reduce toxic parameters and improve clinical results in these settings. However, more studies are needed to further evaluate survival and adverse events based on standardised notification. (C) 2009 Elsevier Espana, S.L. All rights reserved.