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Efficacy of molecular adsorbent recirculating system for the treatment of intractable pruritus in cholestasis

2003; Elsevier BV; Volume: 114; Issue: 1 Linguagem: Inglês

10.1016/s0002-9343(02)01354-2

1555-7162

Manuel Macía, J. Avilés, Juan F. Navarro‐González, Silvia Morales, Javier Eduardo García‐Castañeda,

Drug-Induced Hepatotoxicity and Protection

Generalized pruritus related to cholestasis is a distressing symptom that affects quality of life in several ways, including limitation of normal activities and sleep deprivation. Pharmacologic interventions, such as opiate antagonists, and extracorporeal therapies, such as plasmapheresis or charcoal hemoperfusion ( 1 Jones E.A. Bergasa N.V. The pathogenesis and treatment of pruritus and fatigue in patients with PBC. Eur J Gastroenterol Hepatol. 1999; 11: 623-631 Crossref PubMed Scopus (45) Google Scholar ), have limited efficacy. In some cases, orthotopic liver transplantation is the only effective therapy ( 2 Jones E.A. Bergasa N.V. Evolving concepts of the pathogenesis and treatment of the pruritus of cholestasis. Can J Gastronenterol. 2000; 14: 33-39 PubMed Google Scholar ). However, a new artificial liver support device, molecular adsorbent recirculating system (MARS; Teraklin-AFG, Rostock, Germany), has been shown to be promising in patients with severe complications of advanced liver failure, such as hepatic encephalopathy and hepatorenal syndrome ( 3 Mitzner S.R. Stange J. Klammt S. et al. Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure. J Am Soc Nephrol. 2001; 12: S75-S82 PubMed Google Scholar , 4 Avilés J. Macia M. Morales S. et al. Eficacia de la diálisis con albúmina en el tratamiento de los pacientes con insuficiencia hepática avanzada: primera experiencia en España con el sistema MARS. Nefrologia. 2001; 21: 376-385 PubMed Google Scholar , 5 Stange J. Mitzner S.R. Klammt S. et al. Liver support by extracorporeal blood purification a clinical observation. Liver Transplant. 2000; 6: 603-613 Crossref PubMed Scopus (132) Google Scholar ). We report our experience with MARS in the treatment of intractable pruritus in 3 patients with cholestasis.