Blood detoxification via albumin dialysis

Albumin dialysis is an extracorporeal detoxification technique primarily used as supportive therapy in patients with severe liver dysfunction. The key technology, Molecular Adsorbent Recirculating System (MARS), offsets the accumulation of albumin-bound and water-soluble toxins by using a circuit wherein patient blood is dialyzed against an albumin-containing solution, which absorbs toxins that are subsequently removed via adsorbent columns (such as charcoal and ion exchangers). Several device platforms exist (MARS, OPAL, ADVOS, SPAD, Prometheus), each employing variations on this core principle. This therapy enables selective removal of toxic metabolites, such as bilirubin, bile acids, and albumin-bound pharmaceuticals, without significantly removing essential larger proteins. It is a procedure rather than a single pharmacological target or molecule, and is primarily indicated in acute or acute-on-chronic liver failure, severe cholestatic drug-induced liver injury, and select cases of intractable pruritus

Other names

Albumin dialysisMolecular adsorbent recirculating system (MARS)OPAL (Open Albumin Dialysis)Advanced organ support (ADVOS)Single pass albumin dialysis (SPAD)Fractionated plasma separation and adsorption (Prometheus system)

Removal of albumin-bound and water-soluble toxins from blood via selective filtration and adsorption using an albumin-enriched dialysate and various adsorbent columns Regeneration of albumin in the dialysate circuit via charcoal and anion-exchange columns