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Meta-Analysis
. 2015 Jul 28;21(28):8697-710.
doi: 10.3748/wjg.v21.i28.8697.

Autologous bone marrow transplantation in decompensated liver: Systematic review and meta-analysis

Prasoon Pankaj  1 , Qi Zhang  1 , Xue-Li Bai  1 , Ting-Bo Liang  1
Affiliations
Meta-Analysis

Autologous bone marrow transplantation in decompensated liver: Systematic review and meta-analysis

Prasoon Pankaj et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the efficacy of autologous bone marrow mononuclear cell transplantation in decompensated liver disease.

Methods: Medline, EMBASE, PubMed, Science Direct, and the Cochrane Library were searched for relevant studies. Retrospective case-control studies were included along with randomized clinical trials. Meta-analysis was performed in line with recommendations from the Cochrane Collaboration software review manager. Heterogeneity was assessed using a random-effects model.

Results: Four randomized controlled trials and four retrospective studies were included. Cell transplantation increased serum albumin level by 1.96 g/L (95%CI: 0.74-3.17; P = 0.002], 2.55 g/L (95%CI: 0.32-4.79; P = 0.03), and 3.65 g/L (95%CI: 0.76-6.54; P = 0.01) after 1, 3, and 6 mo, respectively. Patients who had undergone cell transplantation also had a lower level of total bilirubin [mean difference (MD): -1.37 mg/dL; 95%CI: -2.68-(-0.06); P = 0.04] after 6 mo. This decreased after 1 year when compared to standard treatment (MD: -1.26; 95%CI: -2.48-(-0.03); P = 0.04]. A temporary decrease in alanine transaminase and aspartate transaminase were significant in the cell transplantation group. However, after 6 mo treatment, patients who had undergone cell transplantation had a slightly longer prothrombin time (MD: 5.66 s, 95%CI: 0.04-11.28; P = 0.05). Changes in the model for end-stage liver disease score and Child-Pugh score were not statistically significant.

Conclusion: Autologous bone marrow transplantation showed some benefits in patients with decompensated liver disease. However, further studies are still needed to verify its role in clinical treatment for end-stage liver disease.

Keywords: Autologous transplantation; Bone marrow; Cirrhosis; Decompensated liver disease.

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Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Changes in albumin level at 1 mo (A), 3 mo (B), 6 mo (C), and 12 mo (D) after autologous bone marrow transplantation.
Figure 3
Figure 3
Changes in total bilirubin level at 1 mo (A), 3 mo (B), 6 mo (C), and 12 mo (D) after autologous bone marrow transplantation.
Figure 4
Figure 4
Changes in aspartate transaminase level at 3 mo (A) and 6 mo (B) after autologous bone marrow transplantation.
Figure 5
Figure 5
Changes in alanine transaminase level at 3 mo (A) and 6 mo (B) after autologous bone marrow transplantation.
Figure 6
Figure 6
Changes in model for end-stage liver disease score at 1 mo (A), 3 mo (B), 6 mo (C), and 12 mo (D) after autologous bone marrow transplantation.
Figure 7
Figure 7
Changes in Child-Pugh score at 3 mo (A), 6 mo (B), and 12 mo (C) after autologous bone marrow transplantation.
Figure 8
Figure 8
Changes in prothrombin time at 1 mo (A), 6 mo (B), and 12 mo (C) after autologous bone marrow transplantation.
See this image and copyright information in PMC

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