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Related Experiment Videos

Artificial and bioartificial support systems for liver failure.

J P Liu1, L L Gluud, B Als-Nielsen

  • 1Copenhagen Trial Unit, Centre for Clinical Intervention Research, H:S Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark, DK 2100.

The Cochrane Database of Systematic Reviews
|February 20, 2004
PubMed
Summary
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Artificial and bioartificial liver support systems show promise in reducing mortality for acute-on-chronic liver failure. However, further randomized clinical trials are necessary to confirm efficacy and guide routine use in liver failure patients.

Area of Science:

  • Hepatology
  • Critical Care Medicine
  • Biomedical Engineering

Background:

  • Acute and acute-on-chronic liver failure pose significant clinical challenges.
  • Artificial and bioartificial liver support systems offer potential therapeutic strategies.
  • These systems aim to bridge patients to recovery or liver transplantation.

Purpose of the Study:

  • To systematically evaluate the efficacy and safety of artificial and bioartificial liver support systems.
  • To assess the impact of these systems on mortality and hepatic encephalopathy.
  • To explore factors influencing treatment outcomes in different types of liver failure.

Main Methods:

  • Comprehensive literature search across multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to September 2002.

Related Experiment Videos

  • Inclusion of randomized clinical trials (RCTs) and non-randomized studies for explorative analysis.
  • Independent data extraction by three reviewers, with mortality as the primary outcome and analysis using relative risks (RR) and confidence intervals (CI).

    • Main Results:

    • Support systems showed no significant effect on overall mortality or bridging to transplantation compared to standard therapy.
    • A significant beneficial effect on hepatic encephalopathy was observed (RR 0.67; 95% CI 0.52-0.86).
    • Artificial support systems demonstrated a potential mortality reduction in acute-on-chronic liver failure (RR 0.67; 95% CI 0.51-0.90), but not in acute liver failure.

    Conclusions:

    • Artificial support systems may reduce mortality in acute-on-chronic liver failure.
    • No significant impact on mortality was observed for acute liver failure.
    • Additional high-quality randomized clinical trials are required to establish definitive recommendations for routine use.