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Evidence summaries

Artificial and Bioartificial Support Systems for Liver Failure

Artificial support systems may reduce mortality in acute-on-chronic liver failure. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 14 studies with a total of 483 subjects. Compared to standard medical therapy, support systems had no significant effect on mortality (RR 0.86; 95% CI 0.65-1.12) or bridging to liver transplantation (RR 0.87; 95% CI 0.73-1.05), but a significant beneficial effect on hepatic encephalopathy (RR 0.67; 95% CI 0.52-0.86). In subgroup analyses, artificial support systems appeared to reduce mortality by 33% in acute-on-chronic liver failure (RR 0.67; 95% CI 0.51-0.90), but not in acute liver failure (RR 0.95; 95% CI 0.71-1.29).

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies) and by imprecise results (limited study size for each comparison).

    References

    • Liu JP, Gluud LL, Als-Nielsen B, Gluud C. Artificial and bioartificial support systems for liver failure. Cochrane Database Syst Rev 2004;(1):CD003628. [PubMed]

Primary/Secondary Keywords