Abstract: TH-PO249
Molecular Adsorbent Recirculating System (MARS) in Pediatric Patients
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Delgado, Kenneth Michael, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Krallman, Kelli A., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Flores, Francisco X., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
Background
The Molecular Adsorbent Recirculating System (MARS®) uses an albumin enriched dialysis solution to remove protein-bound molecules that are not removed by conventional renal replacement therapy. Its use was approved in the United States for management of drug overdose and intoxication. Other proposed indications include acute liver failure and Data regarding the efficacy of MARS® in pediatric patients remain scarce.
Methods
Retrospective analysis of patients who received MARS® therapy at Cincinnati Children's Hospital Medical Center between January 1st, 2018 and November 30th, 2020. Collected data included age, sex, laboratory data, medical history, vascular catheter size, specifics of therapy, complications, and outcomes. Data existing in the electronic medical record were transcribed by investigators into a secure database.
Results
17/25 patients demonstrated at least one sign of clinical improvement. 13/22 patients experienced improvement in encephalopathy. 6/20 patients demonstrated hepatic recovery. 6/18 patients experienced renal recovery. 4/21 patients underwent liver transplant. 16/25 patients survived until ICU discharge. Youngest patient to receive MARS® was 29 days old. Lowest weight was 2.1 kilograms.
Conclusion
We provide data on pediatric patients receiving MARS® at a high-volume tertiary care center. To our knowledge, this is the largest study on pediatric MARS® to date. We plan to expand this analysis to include data from 2014 – 2018 and 2020 – 2024.
| Demographics | Media(IQR) or N |
| Unique Patients | 23 |
| Courses of Treatment | 25 |
| # of Procedures | 83 |
| Age | 13.2 years (3.8, 17.9) |
| Weight | 41.7 kg (18.6, 60.3) |
| Sex | Males: 12 Females: 13 |
| Invasive Mechanical Ventilation at Initiation | Yes: 14 No: 10 |
| Multiorgan Dysfunction at Initiation | Yes: 21 No: 4 |
| CRRT at Initiation | Yes: 17 No: 8 |
| Anticoagulation | Citrate: 57 Heparin: 18 None: 8 |