Artificial liver support system for acute-on-chronic liver failure: a Meta-analysis

Objective To explore a time series based meta-analysis of randomized clinical trials (RCTs) and observational studies which examined differences in mortality in acute-on-chronic liver failure (ACLF) patients treated with artificial liver support system(ALSS) or not. Methods Medline, Embase, Ovid, and Cochrane library database was systemically searched up to December 2014. The outcome measure was mortality at different follow-up endpoints. Relative risks (RRs) were pooled for analysis. Results Ten studies, involving a total of 1682 ACLF patients, among whom 842 were treated with ALSS. ALSS was found to reduce the risk of 1-month and 3-month mortality for patients with ACLF by nearly 16.4% and 13.2%, respectively. Randomized trials and observational studies provided good internal and external validity, respectively. Conclusions ALSS therapy could reduce short-term mortality in patients with ACLF. Clinical utility of this system for survival benefit may be implied. Key words: Liver, artificial; Liver failure, acute/TH; Mortality; Meta-analysis