A RANDOMISED CONTROLLED TRIAL OF THE USE OF ALBUMIN DIALYSIS (MARS) IN FULMINANT HEPATIC FAILURE DUE TO PARACETAMOL POISONING.

Paracetamol poisoning is the commonest cause of acute liver failure in Great Britain, with a mortality up to 90% and, despite improvements in supportive care, the most severely affected individuals require liver transplantation in order to survive. The Molecular Adsorbent Recirculating System (MARS) is an albumin dialysis system that has been used with success in the treatment of a variety of liver diseases such as hepatorenal syndrome and acute on chronic liver failure. There was a significant improvement in survival with the use of MARS in this group of patients with severe fulminant hepatic failure. This may provide a safe and promising therapeutic intervention in patients ineligible for transplantation and in bridging those eligible for transplantation to surgery in a more stable condition.