Effect of two different extracorporeal liver assist devices on serum bile acids in patients with acute-on-chronic liver failure

Introduction: Elimination of albumin-bound toxins by extracorporeal liver assist devices may be beneficial in acute-on-chronic liver failure. Hydrophobic bile acids may be hepatotoxic when accumulating at high concentrations within the hepatocyte. Both the Molecular Adsorbents Recirculating System (MARS™) and Fractionated Plasma Separation, Adsorption and Dialysis (Prometheus™) have been shown to eliminate total bile acids (BA). However, the two systems have never been compared directly. The aim of this study was to compare elimination of total and individual BA by MARS (M) and Prometheus (P). Methods: Eight pat…