Artificial Liver Support (MARS)

A Bridge, Not a Cure But Sometimes the Difference That Matters Most

When the liver fails suddenly and severely, toxins that a healthy liver would normally clear can build up rapidly in the bloodstream, affecting the brain, circulation and other organs. Artificial liver support systems were developed to help manage this not to replace the liver permanently, but to buy critical time for the liver to recover, or for a transplant to become available.

MARS, the Molecular Adsorbent Recirculating System, is a form of albumin dialysis. It works by passing blood across a specialised membrane against an albumin solution, which is then cleansed and recirculated, removing both protein-bound toxins like bilirubin and bile acids and water-soluble toxins, such as ammonia, from the bloodstream.

At the practice of Dr. Ashok Choudhury, MARS therapy is used selectively, in carefully chosen patients with acute liver failure or acute-on-chronic liver failure, as one part of a broader intensive care and transplant-coordination strategy.

MARS Can Buy Critical Time

Understanding what it does and does not do

MARS is not a permanent liver replacement, and it is not appropriate for every patient with liver failure. Understanding exactly what it offers helps set realistic, honest expectations.

The next step is to understand:

  • Whether MARS is appropriate for your specific type of liver failure
  • What the treatment is actually intended to achieve
  • Whether it is being used to support recovery, or to bridge to transplant
  • How many sessions are typically needed
  • What monitoring takes place during and after treatment
  • How response to treatment is assessed

The goal is not to claim MARS as a cure. It is to use it, where appropriate, to support the body through a critical window of time.

Our Approach to Artificial Liver Support

1. Understand What MARS Does

MARS is designed to temporarily take over some of the detoxifying work the liver would normally perform.

This includes:

  • Albumin dialysis technology Blood is filtered against an albumin solution across a specialized membrane, allowing removal of toxins that ordinary dialysis cannot clear.
  • Removal of protein-bound toxins Substances such as bilirubin and bile acids, which build up in liver failure, are specifically targeted by this technology.
  • Removal of water-soluble toxins Ammonia and other water-soluble substances, relevant to hepatic encephalopathy, are also cleared during treatment.
  • A bridge, not a replacement MARS supports the body while the liver has a chance to recover, or while a transplant is being arranged. it does not replace liver function long-term.

2. Determine Candidacy Carefully

MARS is used selectively, based on the specific type and severity of liver failure, and the overall clinical picture.

Assessment may include looking at:

  • Type of liver failure Acute liver failure, acute-on-chronic liver failure, and post-transplant graft dysfunction are the main situations where MARS may be considered.
  • Haemodynamic stability Patients need to be stable enough to tolerate the treatment safely, which is carefully assessed beforehand.
  • Realistic goals of treatment Whether the aim is to support spontaneous recovery or to bridge to transplant shapes how the treatment is planned and monitored.
  • Weighing potential benefit against risk As with any intensive intervention, the decision to proceed is individualized, weighing likely benefit against the demands of the treatment itself.

3. Deliver and Monitor Treatment Closely

MARS sessions are delivered in a closely monitored setting, typically as part of intensive or high-dependency care.

  • Structured treatment sessions Sessions generally last several hours and may be repeated over consecutive days, depending on the clinical response.
  • Continuous monitoring Vital signs, coagulation status and electrolytes are monitored closely throughout each session, given the intensity of the treatment.
  • Reassessing liver function between sessions Bloodwork and clinical status are reviewed between sessions to judge whether treatment is having the intended effect.
  • Coordinated intensive care MARS is delivered alongside, not instead of, broader intensive care support for other organ systems where needed.

4. Plan the Next Steps

Every MARS treatment course is part of a larger plan, not a standalone intervention.

  • Bridging to transplant For eligible patients, MARS may help maintain stability while transplant evaluation and listing proceed urgently.
  • Supporting spontaneous recovery In some cases, particularly certain forms of acute liver failure, MARS supports the body while the native liver recovers on its own.
  • Ongoing coordination Close communication with intensive care and transplant teams continues throughout treatment, since the overall plan may shift as the clinical picture evolves.
  • Honest reassessment The decision to continue, adjust or stop MARS therapy is revisited regularly, based on how the patient is actually responding.

Setting Realistic Expectations

It’s important to be direct: MARS has been shown to improve certain markers of liver failure and can provide meaningful short-term stabilisation, but it has not been definitively shown to improve survival on its own in all patient groups. Its real value lies in the time it can buy time that may allow the liver to recover, or time that may allow a transplant to happen. It is one tool within a much larger, coordinated critical care strategy, not a stand-alone solution.

A Personalized Plan, Not a One-Size-Fits-All Answer

The decision to use MARS, and how it fits into your broader treatment plan, depends entirely on your specific type of liver failure and overall clinical situation. At the practice of Dr. Ashok Choudhury, this decision is made carefully, honestly, and in close coordination with the wider intensive care and transplant team involved in your care.

If you or a family member is being considered for artificial liver support, a direct conversation about goals, expectations and next steps is an important part of that decision.

Disclaimer

This information is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Please consult a qualified healthcare provider regarding your specific condition.