Therapeutic effect of mesenchymal stem cells on acute-on-chronic liver failure： A Meta-analysis
- VernacularTitle:间充质干细胞对慢加急性肝衰竭治疗效果的Meta分析
- Author:
Hang DING
1
;
Xiaofen LI
1
;
Yan XIONG
1
;
Yanyan LI
1
;
Xiuji CHEN
1
;
Xiaolin WANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Acute-On-Chronic Liver Failure; Mesenchymal Stem Cells; Treatment Outcome; Meta-Analysis
- From: Journal of Clinical Hepatology 2024;40(8):1646-1652
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo systematically evaluate the efficacy and safety of mesenchymal stem cells （MSC） in the treatment of acute-on-chronic liver failure （ACLF）. MethodsThis study was conducted according to PRISMA guidelines， with the PROSPERO registration number of CRD42024517851. PubMed， Embase， Wanfang Data， VIP， CNKI， CBM， and the Cochrane Library were searched for randomized controlled trials （RCT） and cohort studies on MSC in the treatment of ACLF published up to November 1， 2023， and the articles were screened according to inclusion and exclusion criteria. After data extraction and quality assessment， RevMan 5.3 software was used to perform the Meta-analysis. ResultsA total of 11 articles involving 803 subjects were included in this meta-analysis. The results showed that for the patients with ACLF， MSC could improve 8-week survival rate （odds ratio ［OR］=2.71， 95% confidence interval ［CI］： 1.58 — 4.67， P=0.000 3）， 12-week survival rate （OR=2.24， 95%CI： 1.36 — 3.69， P=0.001）， 24-week survival rate （OR=2.09， 95%CI： 1.37 — 3.17， P=0.000 6）， and 48-week survival rate （OR=2.09， 95%CI： 1.29 — 3.40， P=0.003） and reduce 12-week Model for End-Stage Liver Disease （MELD） score （mean difference ［MD］=-3.27， 95%CI： -6.07 to -0.48， P=0.02） and 24-week MELD score （MD=-2.24， 95%CI： -3.16 to -1.33， P<0.000 01）； it could also reduce the level of total bilirubin after 4 weeks of treatment （MD=-36.86， 95%CI： -48.72 to -25.01， P<0.000 01） and increase 4-week albumin level （MD=2.11， 95%CI： 0.62 — 3.61， P=0.006） and 24-week albumin level （MD=3.54， 95%CI： 2.06 — 5.02， P<0.000 01）. Adverse events were evaluated in 6 studies， with no serious adverse events. ConclusionMSC have a good safety in treatment and can improve the survival rate of patients and enhance liver function to some extent， and therefore， it holds promise for clinical application.
