Use of the molecular adsorbent recirculating system (MARS™) for the management of acute poisoning with or without liver failure

Clinical Toxicology

Volumn 49, Issue 9, 2011, Pages 782-793

  Wittebole, Xavier ^a   Hantson, Philippe ^a  

^a CLINIQUES UNIVERSITAIRES SAINT LUC   (Belgium)

Author keywords

Acute poisoning; Dialysis; Extracorporeal liver assist devices; Liver failure; MARS

Indexed keywords

ACTIVATED CARBON; ALBUMIN; ALLOPURINOL; AMANITIN; AMINO ACID; AMMONIA; AMPHETAMINE; ANTIBIOTIC AGENT; BILE ACID; BILIRUBIN; CALCIUM CHANNEL BLOCKING AGENT; COCAINE; CREATININE; CYTOKINE; DIAZEPAM; DILTIAZEM; DISULFIRAM; DOXENITOIN; FENTANYL; HEAVY METAL; LAMOTRIGINE; MIDAZOLAM; NIMESULIDE; NITRIC OXIDE; PARACETAMOL; PHENYTOIN; THEOPHYLLINE; TUBERCULOSTATIC AGENT; UREA; VASOACTIVE AGENT;

ACUTE LIVER FAILURE; ACUTE ON CHRONIC LIVER FAILURE; ALBUMIN DIALYSIS; AMANITA PHALLOIDES; DISEASE COURSE; DRUG ELIMINATION; DRUG INTOXICATION; DRUG OVERDOSE; EPILEPSY; EXTRACORPOREAL CIRCULATION; FUNCTIONAL STATUS; HUMAN; LIVER CELL; LIVER TOXICITY; LIVER TRANSPLANTATION; MUSHROOM POISONING; NONHUMAN; PATHOPHYSIOLOGY; REVIEW; TREATMENT OUTCOME; VIRUS TRANSMISSION;

ACETAMINOPHEN; ACUTE DISEASE; ALBUMINS; AMANITA; AMPHETAMINE; CALCIUM CHANNEL BLOCKERS; COCAINE; HUMANS; LIVER FAILURE; LIVER, ARTIFICIAL; METALS, HEAVY; MUSHROOM POISONING; PHENYTOIN; POISONING; SORPTION DETOXIFICATION; TRIAZINES;

AMANITA PHALLOIDES; BASIDIOMYCOTA; SUS;

EID: 81255163407     PISSN: 15563650     EISSN: 15569519     Source Type: Journal    
DOI: 10.3109/15563650.2011.624102     Document Type: Review

References (105)

1. Bernuau J, Rueff B, Benhamou JP. Fulminant and subfulminant liver failure: Defi nitions and causes. Semin Liver Dis 1986; 6:97-106.
2. O' G rady JG, Alexander GJM, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989; 97:439-445.
3. Mitzner SR. Extracorporeal liver support-albumin dialysis with the molecular adsorbent recirculating system. Ann Hepatol 2011; 10:S21-S28.
4. Pitkin Z, Mullon C. Evidence of absence of porcine endogenous retrovirus (PERV) infection in patients treated with a bioartifi cial liver support system. Artif Organs 1999; 23:829-833.
5. Mitzner SR, Stange J, Klammt S, Risler T, Erley CM, Bader BD, et al. Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: Results of a prospective, randomized, controlled clinical trial. Liver Transpl 2000; 6:277-286.
6. Heemann U, Treichel U, Loock J, Philipp T, Gerken G, Malago M, et al. Albumin dialysis in cirrhosis with superimposed acute liver injury: A prospective, controlled study. Hepatology 2002; 36:949-958.
7. Sen S, Mookerjee RP, Cheshire LM, Davies NA, Williams R, Jalan R. Albumin dialysis reduces portal pressure acutely in patients with severe alcoholic hepatitis. J Hepatol 2005; 43:142-148.
8. Schmidt LE, Svendsen LB, Sorensen VR, Hansen BA, Larsen FS. Cerebral blood fl ow velocity increases during a single treatment with the Molecular Adsorbent Recirculating System in patients with acute on chronic liver failure. Liver Transpl 2001; 7:709-712.
9. Laleman W, Wilmer A, Evenepoel P, Verslype C, Fevery J, Nevens F. Review article: non-biological liver support in liver failure. Aliment Pharmacol Ther 2006; 23:351-363.
10. Kantola T, Koivusalo AM, Höckerstedt K, Isoniemi H. The effect of molecular adsorbent recirculating system treatment on survival, native liver recovery, and need for liver transplantation in acute liver failure patients. Transpl Int 2008; 21:857-866.
11. Saliba F, Camus C, Durand F, Mathurin P, Delafosse B, Barange K, et al. Etude prospective, randomisée, multicentrique, é valuant l'effi cacité et la tol é rance du systeme de dialyse MARS chez les patients atteints d une h é patite fulminante en attente de transplantation. Gastroenterol Clin Biol 2009; 33:A145.
12. Schmidt LE, Wang LP, Hansen BA, Larsen FS. Systemic hemodynamic effects of treatment with the molecular adsorbent recirculating system in patients with hyperacute liver failure: A prospective controlled trial. Liver Transpl 2003; 9:290-297.
13. Ben Abraham R, Szold O, Merhav H, Biderman P, Kidron A, Nakache R, et al. Rapid resolution of brain edema and improved cerebral perfusion pressure following the molecular adsorbent recycling system in acute liver failure patients. Transplant Proc 2001; 33:2897-2899.
14. Record CO, Buxton B, Chase RA, Curzon G, Murray-Lyon IM, Williams R. Plasma and brain amino acids in fulminant hepatic failure and their relationship to hepatic encephalopathy. Eur. J. Clin Invest 1976; 6:387-394.
15. Fischer JE, Funovics JM, Aguirre A, James JH, Keane JM, Wesdorp RI, et al. The role of plasma amino acids in hepatic encephalopathy. Surgery 1975; 78:279-290.
16. Awad SS, Swaniker F, Magee J, Punch J, Bartlett RH. Results of a phase I trial evaluating a liver support device utilizing albumin dialysis. Surgery 2001; 130:354-362.
17. Loock J, Mitzner SR, Peters E, Scmidt R, Stange J. Amino acid dysbalance in liver failure is favourably infl uenced by recirculating albumin dialysis (MARS). Liver 2002; 22:35-39.
18. Schmidt LE, Tofteng F, Strauss GI, Larsen FS. Effect of treatment with the Molecular Adsorbents Recirculating System on arterial amino acid levels and cerebral amino acid metabolism in patients with hepatic encephalopathy. Scand J Gastroenterol 2004; 39:974-980.
19. Koivusalo AM, Teikari T, Höckerstedt K, Isoniemi H. Albumin dialysis has a favorable effect on amino acid profi le in hepatic encephalopathy. Metab Brain Dis 2008; 23:387-398.
20. Mitzner SR, Stange J, Klammt S, Peszynski P, Schmidt R, Noeldge- Schomburg G. Extracorporeal detoxifi cation using the molecular adsorbent recirculating system for critically ill patient with liver failure. J Am Soc Nephrol 2001; 12:S75-S82.
21. Mitzner SR, Stange J, Klammt S, Peszynski P, Schmidt R. Albumin dialysis using the MARS system. Curr Opin Nephrol Hypertens 2001; 10:777-783.
22. Guo LM, Liu JY, Xu DZ, Li BS, Han H, Wang LH, et al. Application of Molecular Adorbent Recirculating System to remove NO and cytokines in severe liver failure patients with multiple organ dysfunction syndrome. Liver Int 2003; 23(S3):16-20.
23. Sen S, Davies NA, Mookerjee RP, Cheshire LM, Hodges SJ, Williams R, Jalan R. Pathophysiological effects of albumin dialysis in acute-on-chronic liver failure: A prospective randomised controlled study. Liver Transpl 2004; 10:1109-1119.
24. Di Campli C, Zocco MA, Gaspari R, Novi M, Candelli M, Santoliquido A, et al. The decrease in cytokine concentration during albumin dialysis correlates with the prognosis of patients with acute on chronic liver failure. Transpl Proceed 2005; 37:2551-2553.
25. Auth MK, Kim HS, Beste M, Bonzel KE, Baumann U, Ballauff A, et al. Removal of metabolites, cytokines and hepatic growth factors by extracorporeal liver support in children. J Ped Gastoenterol Nutr 2005; 40:54-59.
26. Novelli G, Amnesini MC, Morabito V, Cinti P, Pugliese F, Novelli S, et al. Cytokine level modifi cations: molecular adsorbent recirculating system versus standard medical therapy. Transplant Proc 2009; 41:1243-1248.
27. Isionemi H, Koivusalo AM, Repo H, Ilonen I, Höckerstedt K. The effect of albumin dialysis on cytokine levels in acute liver failure and need for liver transplantation. Transpl Proceed 2005; 37:1088-1090.
28. Falkenhagen D, Strobl W, Vogt G, Schrefl A, Linsberger I, Gerner FJ, et al. Fractionated Plasma Separation and Adsorption System: A Novel System for Blood Purifi cation to Remove Albumin Bound Substances. Artif Organs 1999; 23:81-86.
29. Evenepoel P, Laleman W, Wilmer A, Claes K, Kuypers D, Bammens B, et al. Prometheus Versus Molecular Adsorbent Recirculating System: Comparison of Effi ciency in Two Different Liver Detoxifi cation Devices. Artif Organs 2006; 30:276-284.
30. Rifai K, Ernst T, Kretschmer U, Haller H, Manns MP, Fliser D. Removal selectivity of Prometheus: A new extracorporeal liver support device. World J Gastroenterol 2006; 12:940-944.
31. Peszynski P, Stange J, Mitzner S, Klammt S, Majcher-Peszynska J. Wacke R, et al. Removal of benzodiazepine-like substances as a cause of improvement of hepatic encephalopathy during albumin dialysis. Z Gastroenterol 2001; 39:53.
32. Sen S, Ytrebo LM, Rose C, Fuskevaag OM, Davies NA, Nedredal GI, et al. Albumin dialysis: A new therapeutic strategy for intoxication from protein-bound drugs. Intensive Care Med 2004; 30:496-501.
33. Pugliese F, Novelli G, Poli L, Levi Sandri GB, Di Folco G, Ferretti S, et al. Hemodynamic improvement as an additional parameter to evaluate the safety and tolerability of the Molecular Adsorbent Recirculating System in liver failure patients. Transplant Proc 2008; 40: 1925-1928.
34. Lai WK, Haydon G, Mutimer D, Murphy N. The effect of molecular adsorbent recirculating system on pathophysiological parameters in patients with acute liver failure. Intensive Care Med 2005; 31: 1544-1549.
35. Sen S, Rose C, Ytrebo LM, Davies NA, Nedredal GI, Drevland SS, et al. Effect of albumin dialysis on intracranial pressure increase in pigs with acute liver failure: A randomised study. Crit Care Med 2006; 34:158-164.
36. Sorkine P, Ben Abraham R, Szold O, Biderman P, Kidron A, Merchav H, Role of the molecular adsorbent recycling system (MARS) in the treatment of patients with acute exacerbation of chronic liver failure. Crit Care Med 2001; 29:1332-1336.
37. Siewert-Delle A, Henriksson BA, Backman L. Albumin dialysis with the M.A.R.S.Molecular Absorbent Recirculating System) for a patient with acute liver failure due to paracetamol intoxication: A case report. Z Gastroenterol 2001; 39:48.
38. Pugliese F, Ruberto F, Perrella SM, Cappannoli A, Bruno K, Martelli S, et al. Modifi cations of intracranial pressure after molecular adsorbent recirculating system treatment in patients with acute liver failure: Case reports. Transplant Proc 2007; 39:2042-2044.
39. Novelli G, Rossi M, Pretagostini R, Ferretti G, Novelli S, Ianni S, et al. A 3-year experience with molecular adsorbent recirculating system (MARS): Our results on 63 patients with hepatic failure and color Doppler US evaluation of cerebral perfusion. Liver Int 2003; 23:10-15.
40. Novelli G, Rossi M, Pretagostini M, Pugliese F, Ruberto F, Novelli L, et al. One hundred sixteen cases of acute liver failure treated with MARS. Transpl Proc 2005; 37:2557-2559.
41. Sussman NL, Chong MG, Koussayer T, He DE, Shang TA, Whisennand HA, Kelly JH. Reversal of fulminant hepatic failure using an extracorporeal liver assist device. Hepatology 1992; 16:60-65.
42. Ellis AJ, Hughes RD, Wendon JA, Dunne J, Langley PG, Kelly JH, et al. Pilot-Controlled Trial of the Extracorporeal Liver Assist Device in Acute Liver Failure. Hepatology 1996; 24:1446-1451.
43. Demetriou AA, Brown RS Jr, Busutill RW, Fair J, McGuire BM, Rosenthal P, et al. Prospective, randomized, multicenter, controlled trial of a bioartifi cial liver in treating acute liver failure. Ann Surg 2004; 239:660-667.
44. McIntyre CW, Fluck RJ, Freeman JG, Lambie SH. Use of albumin dialysis in the treatment of hepatic and renal dysfunction due to paracetamol intoxication. Nephrol Dial Transplant 2002; 17:316-317.
45. Banares Cazinares R, Catalina Rodriguez MV. Indications and therapeutic possibilities of albumin dialysis (MARS). Rev Esp Enferm Dig 2003; 95:876-89.
46. Felldin M, Friman S, Backman L, Siewert-Delle A, Henriksson BA, Larsson B, Olausson M. Treatment with the molecular adsorbent recirculating system in patients with acute liver failure. Transplant Proc 2003; 35:822-823.
47. Koivusalo AM, Yldirim Y, Vakkuri A, Lindgren L, Höckerstedt K, Isionemi H. Experience with albumin dialysis in fi ve patients with severe overdoses of paracetamol. Acta Anaesthesiol Scand 2003; 47:1145-1150.
48. Hydzik P, Drozdz M, Sulowicz W, Groszek B. Liver albumin dialysis - application in acetaminophen poisoning. Przegl Lek 2004; 61:377-382.
49. Lubezky N, Nakache R, Carmiel M, Oren R, Sorkine P, Klausner J, Ben-Haim M. Initial experience with urgent adult-to-adult living donor liver transplantation in fulminant hepatic failure. Isr Med Assoc J 2004; 6:467-470.
50. Zhou XM, Miao JY, Yang Y, Zhao L, Wang X, Xu L, et al. Clinical Experience with Molecular Adsorbent Recirculating System (MARS) in Patients with Drug-induced Liver Failure. Artif Organs 2004; 28:483-486.
51. Camus C, Lavou é S, Gacouin A, Le Tulzo Y, Lorho R, Boudj ém a K, et al. Molecular adsorbent recirculating system dialysis in patients with acute liver failure who are assessed for liver transplantation. Intensive Care Med 2006; 32:1817-1825.
52. Kantola T, Koivusalo AM, Höckerstedt K, Isionemi H. The effect of molecular adsorbent recirculating system treatment on survival, native liver recovery, and need for liver transplantation in acute liver failure patients. Transpl Int 2008; 21:857-66.
53. Novelli G, Rossi M, Morabito V, Pugliese F, Ruberto F, Perrella SM, et al. Pediatric acute liver failure with molecular adsorbent recirculating system treatment. Transplant Proc 2008; 40:1921-1924.
54. Camus C, Lavoué S, Gacouin A, Compagnon P, Boudjé m a K, Jacquelinet C, et al. Liver transplantation avoided in patients with fulminant hepatic failure who received albumin dialysis with the molecular adsorbent recirculating system while on the waiting list: impact of the duration of therapy. Ther Apher Dial 2009; 13: 549-55.
55. Kantola T, Koivusalo A.M., Parmanen S, Höckerstedt K, Isoniemi H. Survival predictors in patients treated with a molecular adsorbent recirculating system. World J Gastroenterol 2009; 15:3015-3024.
56. Koivusalo AM, Kantola T, Arola J, Höckerstedt K, Kairaluoma P, Isionemi H. Is it possible to gain extra waiting time to liver transplantation in acute liver failure patients using albumin dialysis? Ther Apher Dial 2009; 13:556.
57. de Geus H, Mathô t R, van der Hoven B, Tjoa M, Bakker J. Enhanced paracetamol clearance with molecular adsorbents recirculating system (MARS) in severe autointoxication. Blood Purif 2010; 30:118-119.
58. Kantola T, Ilmakunnas M, Koivusalo AM, Isionemi H. Bridging therapies and liver transplantation in acute liver failure, 10 years of MARS experience in Finland. Scand J Surg 2011; 100: 8-13.
59. Skwarek A, Grodzicki M, Nyckowski P, Kotulski M, Zieniewicz K, Michalowicz B, et al. The Use Prometheus FPSA System in the Treatment of Acute Liver Failure: Preliminary Results. Transpl Proc 2006; 38:209-211.
60. Karvellas CJ, Bagshaw SM, McDermid RC, Stollery DE, Gibney RT. Acetaminophen-induced acute liver failure treated with singlepass albumin dialysis: Report of a case. Int J Artif Organs 2008; 31:450-455.
61. Karvellas CJ, Bagshaw SM, McDermid RC, Stollery DE, Bain VG, Gibney RT. A case-control study of single-pass albumin dialysis for acetaminophen-induced acute liver failure. Blood Purif 2009; 28:151-158.
62. Faulstich H. Mushroom poisoning. Lancet 1980; 2:794- 7 95.
63. Wieland T. The toxic peptides from Amanita mushrooms. Int J Pept Protein Res 1983; 22:257-276.
64. Leist M, Gantner F, Naumann H, Bluethmann H, Vogt K, Brigelius- Floh é R, et al. Tumor necrosis factor-induced apoptosis during the poisoning of mice with hepatotoxins. Gastroenterology 1997; 112:923-934.
65. Jaeger A, Jehl F, Flesch F, Sauder P, Kopferschmitt J. Kinetics of amatoxins in human poisoning: Therapeutic implications. J Toxicol Clin. Toxicol. 1993; 31:63-80.
66. Von Clarmann M, Mathes G, Weber T, Erhardt W, Kircher G, Fischer M. Therapy of Amanita phalloides poisoning. Results of clinical and experimental studies. Fortschr Med 1979; 97:1999-2005.
67. Jander S, Bischoff J, Woodcock BG. Plasmapheresis in the treatment of Amanita phalloides poisoning: A review and recommendations. Ther Apher 2000; 4:308-312.
68. Shi Y, He J, Chen S, Zhang L, Yang X, Wang Z, Wang M. MARS: optimistic therapy method in fulminant hepatic failure secondary to cytotoxic mushroom poisoning - a case report. Liver 2002; 22:78-80.
69. Catalina MV, Nunez O, Ponferrada A, Menchen L, Matilla A, Clemente G, Banares R. Liver failure due to mushroom poisoning: Clinical course and new treatment perspectives. Gastroenterol Hepatol 2003; 26:417-420.
70. Covic A, Goldsmith DJA, Gusbeth-Tatomir P, Volovat C, Dimitriu AG, Cristogel F, Bizo A. Successful use of Molecular Absorbent Regenerating System (MARS) dialysis for the treatment of fulminant hepatic failure in children accidentally poisoned by toxic mushroom ingestion. Liver Int 2003; 23:21-27.
71. Faybik P, Hetz H, Baker A, Bittermann C, Berlakovich G, Werba A, et al. Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning. Liver Int 2003; 23:28-33.
72. Rubik J, Pietraszek-Jezierska E, Kaminski A, Skarzynska A, Jozwiak S, Pawlowska J, et al. Successful treatment of a child with fulminant liver failure and coma caused by Amanita phalloides intoxication with albumin dialysis without liver transplantation. Pediatr Transplant 2004; 8:295-300.
73. Wu BF, Wang MM. Molecular adsorbent recirculating system in dealing with maternal Amanita poisoning during the second pregnancy trimester: A case report. Hepatobiliary Pancreat Dis Int 2004; 3:152-154.
74. Hydzik P, Gawlikowski T, Ciszowski K, Kwella N, Sein Anand J, Wojcicki M, et al. Liver albumin dialysis (MARS) - treatment of choice in Amanita phalloides poisoning? Przegl Lek 2005; 62:475-479.
75. Lionte C, Sorodoc L, Simionescu V. Successful treatment of an adult with Amanita phalloides - induced fulminant liver failure with Molecular Adsorbent Recirculating System. Rom J Gastroenterol 2005; 14:267-271.
76. Sein Anand J, Chodorowski Z, Hydzik P. Molecular Adsorbent Recirculating System - MARS as a bridge to liver transplantation in Amanita phalloides intoxication. Przegl Lek 2005; 62:480-481.
77. Sein Anand J, Chodorowski Z, Wisniewski M, Waldman W. The assessment of albumin liver dialysis-MARS effi cacy in the treatment of Amanita phalloides poisoning. Przegl Lek 2007; 64:255-257.
78. Wisniewski M, Lukasik-Glebocka M, Chodorowski Z, Sein Anand J. Albumin dialysis (MARS) vs standard therapy in management of Amanita phalloides poisoning (Abstract). Clin. Toxicol. 2008; 46:402-403.
79. Wisniewski M, Sein Anand J, Hydzik P, Barwina M, Waldman W, Chodorowski Z. Outcome predictors in patients treated with albumin dialysis due to Amanita phalloides poisoning (Abstract). Clin. Toxicol. 2008; 46:408.
80. Kantola T, Kantola T, Koivusalo AM, Höckerstedt K, Isionemi H. Early molecular adsorbents recirculating system treatment in Amanita mushroom poisoning. Ther Apher Dial 2009; 13:399-403.
81. Sorodoc L, Lionte C, Sorodoc V, Petris O, Jaba I. Is MARS system enough for A. phalloides-induced liver failure treatment. Hum Exp Toxicol 2010; 29:823-832.
82. Kramer L, Bauer E, Schenk P, Steininger R, Vigl M, Mallek R. Successful treatment of refractory cerebral edema in ecstasy/ cocaine-induced fulminant hepatic failure using a new high-effi cacy liver detoxifi cation device (FPSA-Prometheus). Wien Klin Wochenschr 2003; 115:599-603.
83. Sein Anand J, Chodorowski Z, Wisniewski M. Molecular Adsorbent Recirculating System (MARS) a helpful procedure in acute liver failure caused by synthetic amphetamines intoxication. Przegl Lek 2006; 63:514-515.
84. Choi JY, Bae SH, Yoon SK, Cho SH, Yang JM, Han JY, et al. Preconditioning by extracorporeal liver support (MARS) of patients with cirrhosis and severe liver failure evaluated for living donor transplantation - a pilot study. Liver Int 2005; 25:740-745.
85. Lee KH, Lee MK, Sutedja DS, Lim SJ. Outcome from molecular adsorbent recycling system (MARS) liver dialysis following druginduced liver failure. Liver Int 2005; 25:973-977.
86. Yang WS, Tan HK, Lui HF, Chow PK, Choong HL, Wong KS. Albumin dialysis in critically ill patients: use versus omission of intradialytic heparin. Artif Organs 2008; 32:411-416.
87. Doria C, Mandala L, Scott VL, Gruttadauria S, Marino IR. Fulminant Hepatic Failure Bridged to Liver Transplantation with a Molecular Adsorbent Recirculating System: A Single-Centre Experience. Dig Dis Sci 2006; 51:47-53.
88. Page M, Christin F, Hayi-Slayman D, Baillon JJ, Ber CE, Delafosse B, et al. Acute liver failure due to nimesulide: Another case and review. Ann Fr Anesth Rean 2008; 27:242-246.
89. Braun RC, Birck R, Singer MV, Schnuelle P, van der Woude FJ, Löhr M. Life-threatening intoxication with methylenebis( thiocyanate): Clinical picture and pitfalls. A case report. BMC Emerg Med 2006; 6:5.
90. Fagugli RM, Gentile G, Ferrara G, Brugnano R. Acute renal and hepatic failure associated with allopurinol treatment. Clin Nephrol 2008; 70:523-536.
91. Chua HC, Venketasubramanian N, Tjia H, Tchan SP. Elimination of phenytoin in toxic overdose. Clin Neurol Neurosurg 2000; 102:6-8.
92. Martin E, Gambertoglio JG, Adler DS, Tozer TN, Roman LA, Grausz H. Removal of phenytoin by hemodialysis in uremic patients. JAMA 1977; 238:1750-1753.
93. Sen S, Ratnaraj N, Davies NA, Mookerjee RP, Cooper CE, Patsalos PN, et al. Treatment of Phenytoin Toxicity with the Molecular Adsorbent Recirculating System (MARS). Epilepsia 2003; 44:265-267.
94. De Schoenmakere G, De Waele J, Terryn W, Deweweire M, Verstraete A, Hoste E, et al. Phenytoin Intoxication in Criticall Ill Patient. Am. J. Kidney Dis 2004; 45:189-192.
95. Brodie MJ. Lamotrigine. Lancet 1992; 339:1397-400.
96. Mecarelli O, Pulitano P, Mingoia M, Ferretti G, Rossi M, Berloco PB, Muda AO. Acute Hepatitis Associated with Lamotrigin and Managed with the Molecular Adsorbent Recirculating System (MARS). Epilepsia 2005; 46:1687-1689.
97. Lee CS, Marbury TC, Perrin JH, Fuller TJ. Hemodialysis of theophyllin in uremic patients. J Clin Pharmacol.1979; 19:219-226.
98. Stange J, Ramlow W, Mitzner S, Schmidt R, Klinkmann H. Dialysis against a recycled albumin solution enables the removal of albuminbound toxins. Artif Organs 1993; 17:809-813.
99. Korsheed S, Selby NM, Fluck RJ. Treatment of severe theophylline poisoning with the molecular adsorbent recirculating system (MARS). Nephrol Dial Transplant 2007; 22:969-970.
100. Higgins RM, Hearing S, Goldsmith DJ, Keevil B, Venning MC, Ackrill P. Severe theophylline poisoning: Charcoal haemoperfusion or haemodialysis. Postgrad Med J 1995; 71:224-226.
101. Shepherd G. Treatment of poisoning caused by beta-adrenergic and calcium-channel blockers. Am. J. Health Syst Pharm 2006; 63:1828-1835.
102. Bloedow DC, Piepho RW, Nies AS, Gal J. Serum binding of diltiazem in humans. J Clin Pharmacol 1982; 22:201-205.
103. Pichon N, Franç o is B, Chevreuil C, Gaulier JM. Albumin dialysis: A new therapeutic alternative for severe diltiazem intoxication. Clin. Toxicol. 2006; 44:195-196.
104. Prokurat S, Grenda R, Lipowski D, Kalicinski P, Migdal M. MARS procedure as a bride to combined kidney-liver transplantation in severe chromium-copper acute intoxication: A paediatric case report. Liver 2002; 22:76-77.
105. Kreymann B, Seyge M, Schweigart U, Kopp KF, Classen M. Albumin dialysis: effective removal of copper in a patient with fulminant Wi disease and successful bridging to liver transplantation: A new possibility for the elimination of protein-bound toxins. J Hepatol 1999; 31:1080-1085.