Solo Journal of Anesthesi, Pain and Critical Care
Vol 5, No 2 (2025): October 2025

Extracorporeal Liver Support in Liver Failure: A Comprehensive Review of MARS, SPAD, Prometheus, ADVOS, and Bioartificial Systems

Synthana, Meta Restu (Unknown)
Jufan, Akhmad Yun (Unknown)
Wisudarti, Calcarina Fitriani Retno (Unknown)
Deviatika, Fiandila Elvana (Unknown)



Article Info

Publish Date
31 Oct 2025

Abstract

Background : Acute and chronic liver failure are life-threatening conditions often requiring liver transplantation as definitive therapy. To delay or substitute the need for transplantation, various extracorporeal liver support systems have been developed. This article aims to review current artificial and bioartificial liver support systems including the Molecular Adsorbent Recirculating System (MARS), Single Pass Albumin Dialysis (SPAD), Prometheus, ADVanced Organ Support (ADVOS), and Bioartificial Liver (BAL) devices.Discussion : MARS and SPAD utilize albumin-based dialysis to remove protein-bound and water-soluble toxins. Prometheus applies a fractionated plasma separation and adsorption approach, while ADVOS enables individualized acid-base correction. Bioartificial liver systems integrate hepatocyte bioreactors with plasma dialysis to provide more physiological metabolic support. While these systems show promise in improving clinical outcomes, long-term survival benefit remains under investigation.Conclusion :  Extracorporeal liver support systems offer essential bridging and supportive therapies for patients with liver failure. Selection should be tailored to patient condition, therapeutic goals, and technology availability.

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Journal Info

Abbrev

SOJA

Publisher

Subject

Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology Nursing Public Health

Description

Case Report, Original Research and Review Article in the scope of : Life Support Emergency and Trauma Cardiovascular Anesthesia Pediatric Anesthesia Neuro Anesthesia Pain Management Intensive Care Obstetry Anesthesia Geriatric and Oncology Anesthesia Regional Anesthesia Ambulatory ...