Artificial liver support devices such as the molecular adsorbent recirculating system (MARS), fractionated plasma separation and adsorption, and therapeutic plasma exchange (TPE) are well tolerated.  MARS and TPE improve systemic haemodynamics and the grade of hepatic encephalopathy.  However, randomized, controlled trials of MARS and fractionated plasma separation and adsorption have failed to show improvement in survival in patients with acute liver failure (ALF) and patients with acute-on-chronic liver failure (ACLF).  Liver support systems such as MARS and TPE may temporarily improve systemic haemodynamics and the degree of encephalopathy. 
MARS