{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:20:42Z","timestamp":1789003242058,"version":"build-2803163510"},"reference-count":24,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;\/i&gt;&lt;\/b&gt; Liver failure is associated with hepatic and extrahepatic organ failure leading to a high short-term mortality rate. Extracorporeal albumin dialysis (ECAD) aims to reduce albumin-bound toxins accumulated during liver failure. ECAD detoxifies blood using albumin dialysis through an artificial semipermeable membrane with recirculation (molecular adsorbent recirculating system, MARS) or without (single-pass albumin dialysis, SPAD). &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; We performed a randomized crossover open trial in a surgical intensive care unit. The primary outcome of the study was total bilirubin reduction during MARS and during SPAD therapies. The secondary outcomes were conjugated bilirubin and bile acid level reduction during MARS and SPAD sessions and tolerance of dialysis system devices. Inclusion criteria were adult patients presenting liver failure with factor V activity &amp;#x3c;50% associated with bilirubin \u2265250 \u03bcmol\/L and a complication (either hepatic encephalopathy, severe pruritus, or hepatorenal syndrome). For MARS and SPAD, the dialysis flow rate was equal to 1,000 mL\/h. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; Twenty crossovers have been performed. Baseline biochemical characteristics (bilirubin, ammonia, bile acids, creatinine, and urea) were not statistically different between MARS and SPAD. Both ECAD have led to a significant reduction in total bilirubin (\u221283 \u00b1 67 \u03bcmol\/L after MARS; \u2212122 \u00b1 118 \u03bcmol\/L after SPAD session), conjugated bilirubin (\u221282 \u00b1 61 \u03bcmol\/L after MARS; \u2212105 \u00b1 96 \u03bcmol\/L after SPAD session), and bile acid levels (\u221264 \u00b1 75 \u03bcmol\/L after MARS; \u221256 \u00b1 56 \u03bcmol\/L after SPAD session), all nondifferent comparing MARS to SPAD. &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; A simple-to-perform SPAD therapy with equal to MARS dialysate flow parameters provides the same efficacy in bilirubin and bile acid removal. However, clinically relevant endpoints have to be evaluated in randomized trials to compare MARS and SPAD therapies and to define the place of SPAD in the liver failure care program. <\/jats:p>","DOI":"10.1159\/000515825","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T21:00:32Z","timestamp":1623963632000},"page":"243-250","source":"Crossref","is-referenced-by-count":16,"title":["Extracorporeal Albumin Dialysis in Liver Failure with MARS and SPAD: A Randomized Crossover Trial"],"prefix":"10.1159","volume":"51","author":[{"given":"Gr\u00e9goire","family":"Wallon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Guth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Guichon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Thevenon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Gazon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Viale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Schoeffler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Duperret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Aubrun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00309-8"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746-6342.2006.03217.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.478"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.25089"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12169"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(72)92821-8"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0453-z"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/b978-0-323-44942-7.00130-8"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003628.pub2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.2.217"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2015.05.004"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-011-2058-8"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2003.50051"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1034\/j.1478-3231.23.s.3.4.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0676.2002.00007.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20195"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2009.00760.x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2009.00758.x"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-1159-3"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000227280"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2011.00980.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/s0041-1345(98)02033-8"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/01.asn.0000131521.62256.f0"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2009.00757.x"}],"container-title":["Blood Purification"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/515825","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/515825","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:38:44Z","timestamp":1745426324000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000515825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,17]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2,28]]},"published-print":{"date-parts":[[2022,3,8]]}},"URL":"https:\/\/doi.org\/10.1159\/000515825","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.14797839","asserted-by":"subject"}]},"ISSN":["0253-5068","1421-9735"],"issn-type":[{"value":"0253-5068","type":"print"},{"value":"1421-9735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,17]]}}}