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Emergency doctors find new life-saving use in old machine

Meredith Cohn, The Baltimore Sun on

Published in News & Features

BALTIMORE -- Slammed in the gut by a wrecking ball, the construction worker arrived at the University of Maryland Shock Trauma Center in dire condition years ago.

Doctors removed his devastated liver but he died before being matched with a new one, frustrating staff that longed for something to temporarily maintain the organ's function, like their machines for hearts, lungs and kidneys.

Now they think they've found one in a little-used machine designed to detoxify people who overdose on acetaminophen and other medications. Doctors at Shock Trauma used it to save a teenage gunshot victim, and then a college football player and an amateur triathlete who suffered heatstrokes.

Twenty-seven patients facing death from liver failure were hooked to the machine from 2013 through 2016 and the majority lived -- a tally Maryland doctors now hope spurs a new look at the old technology.

"Our goal is to continue to increase our patient population and tell people about it," said Dr. Steven I. Hanish, a liver transplant surgeon at the University of Maryland Medical Center who works closely with Shock Trauma and was the lead researcher on a paper about the cases published recently in the Annals of Surgery.

It's an off-label use of the Molecular Adsorbent Recirculating System machine, or MARS, which has been around for decades. MARS is approved by the U.S. Food and Drug Administration only to treat poisoning cases and brain swelling from liver failure. Its manufacturer, Baxter International, says 20 hospitals use it.

 

Livers primarily filter blood coming from the digestive tract, metabolizing toxins such as alcohol and drugs, and creating vital proteins. People cannot live without a functioning liver.

Shock Trauma doctors wanted to try the MARS device as a temporary stand-in for badly damaged livers, giving patients a chance to begin healing or for transplants to be arranged, but first they had to find one.

After checking with Baxter, they found an area hospital that was returning a MARS machine.

"We literally got one off the back of a truck driving up I-95," said Dr. Thomas Scalea, the center's physician-in-chief.

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