Global evidence on molecular adsorbent recirculating system uses for trauma-induced acute liver failure: A scoping review

Table 1 Outcomes of studies included in the scoping review

Ref.	Population	Type of trauma (if applicable)	Intervention	Duration/number of sessions
Ben-Abraham et al[3]; 2003	Post-traumatic acute liver failure due to blunt trauma (n = 1)	Isolated grade V blunt liver trauma with major hepatic necrosis (1/1)	Molecular adsorbent recirculating system	3 sessions of 8 hours
Rittler et al[4]; 2004	Post-operative acute liver failure and septic multiple organ failure (n = 5); includes 1 trauma patient	1 blunt trauma (1/5); no subgroup outcomes reported	Molecular adsorbent recirculating system	Mean 13.4 cycles, 11.8 hours/cycle
Monet et al[14]; 2022	Heterogeneous cohort: Acute-on-chronic liver failure, acute liver failure, post-operative, pruritus, drug intoxication (n = 180)	Trauma listed as 1 of 32 acute liver failure cases; not separately analyzed	Molecular adsorbent recirculating system	Mean 2.9 sessions, 7 hours 33 minutes/session
Powell et al[5]; 2024	Acute liver failure due to trauma, drug toxicity, acute-on-chronic liver failure, others (n = 61)	Includes 8 patients with severe trauma (8/61); trauma-specific outcomes not separately reported	Molecular adsorbent recirculating system, continuous renal replacement therapy, standard medical therapy	1 to > 3 session (majority 3), 8 hours/session

Table 2 Clinical and laboratory outcomes of molecular adsorbent recirculating system therapy in trauma-associated acute liver dysfunction

Ref.	Primary outcomes	Secondary outcomes	Adverse events
Ben-Abraham et al[3]; 2003	Survival 100% (1/1), liver recovery (1/1)	Normalized intracranial pressure, improved bilirubin, ammonia, international normalized ratio, factor V	Not reported
Rittler et al[4]; 2004	Mortality 100% (5/5)	Reduced bilirubin; no improvement in ammonia, coagulopathy	Bleeding, thrombocytopenia
Monet et al[14]; 2022	Survival 40%, transplantation-free (acute liver failure, 13/32); variable by group	Improved bilirubin, prothrombin time, hepatic encephalopathy, pruritus	Thrombocytopenia (30.6%), hypotension, hypothermia
Powell et al[5]; 2024	Survival 50% (4/8 trauma cases)	Improved aspartate aminotransferase, alanine aminotransferase, international normalized ratio, lactic acid; no change in ammonia; no improvement in hepatic encephalopathy	Not reported