Deng Li, Yin Xiuli, Zhao Yingying, Yang Jing, Yang Hongli, Xu Changqing, Li Kun
Department of Gastroenterology, Shandong Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
Department of Gastroenterology, Rongjun Hospital of Shandong Province, Jinan, China.
J Int Med Res. 2020 Dec;48(12):300060520980877. doi: 10.1177/0300060520980877.
In patients with acute liver injury caused by hepatic veno-occlusive disease (HVOD), molecular adsorbent recirculation system (MARS) may be used to improve liver function in conjunction with transjugular intrahepatic portosystemic shunt (TIPS) to reduce portal hypertension.
Twelve patients were admitted to our hospital following treatment for HVOD for 10 to 21 days at other hospitals. All patients were treated with a combination of MARS and TIPS, and they were evaluated clinically including liver function tests.
After the initial treatment with MARS, liver function improved significantly in all patients. TIPS placement decreased the hepatic venous pressure gradient (HVPG) to 10.17 ± 2.26 mmHg from a pre-TIPS HVPG of 23.58 ± 9.43 mmHg. The outcomes of combination treatment with MARS and TIPS in 12 patients with HVOD were as follows: 1) improvement of various clinical and biological parameters leading to full recovery in 1 year in 6 patients; 2) full recovery following liver transplantation for acute liver failure in three patients; and 3) three patients died due to hepatic failure after TIPS placement.
The combination of MARS and TIPS creation is promising as a potential treatment for acute HVOD, and it showed an improvement in overall survival.
在肝静脉闭塞性疾病（HVOD）所致急性肝损伤患者中，分子吸附循环系统（MARS）可与经颈静脉肝内门体分流术（TIPS）联合使用以改善肝功能并降低门静脉高压。
12例患者在其他医院接受HVOD治疗10至21天后入住我院。所有患者均接受MARS和TIPS联合治疗，并对其进行包括肝功能检查在内的临床评估。
经MARS初始治疗后，所有患者肝功能均显著改善。TIPS置入使肝静脉压力梯度（HVPG）从TIPS置入前的23.58±9.43 mmHg降至10.17±2.26 mmHg。12例HVOD患者接受MARS和TIPS联合治疗的结果如下：1）6例患者各种临床和生物学参数改善，1年内完全康复；2）3例患者因急性肝衰竭接受肝移植后完全康复；3）3例患者在TIPS置入后因肝衰竭死亡。
MARS与TIPS联合应用有望成为急性HVOD的一种潜在治疗方法，且显示出总体生存率有所提高。
