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Meta-Analysis
. 2023 Oct 20;14(1):301.
doi: 10.1186/s13287-023-03518-x.

Efficacy and safety of mesenchymal stem cell therapy in liver cirrhosis: a systematic review and meta-analysis

Wenming Lu  1   2   3 , Jiayang Qu  2   3 , Longxiang Yan  2   3 , Xingkun Tang  1   2 , Xuesong Wang  1   2 , Anqi Ye  2 , Zhengwei Zou  1   4 , Lincai Li  1   4 , Junsong Ye  5   6   7   8 , Lin Zhou  9   10   11   12
Affiliations
Meta-Analysis

Efficacy and safety of mesenchymal stem cell therapy in liver cirrhosis: a systematic review and meta-analysis

Wenming Lu et al. Stem Cell Res Ther. .

Abstract

Aim: Although the efficacy and safety of mesenchymal stem cell therapy for liver cirrhosis have been demonstrated in several studies. Clinical cases of mesenchymal stem cell therapy for patients with liver cirrhosis are limited and these studies lack the consistency of treatment effects. This article aimed to systematically investigate the efficacy and safety of mesenchymal stem cells in the treatment of liver cirrhosis.

Method: The data source included PubMed/Medline, Web of Science, EMBASE, and Cochrane Library, from inception to May 2023. Literature was screened by the PICOS principle, followed by literature quality evaluation to assess the risk of bias. Finally, the data from each study's outcome indicators were extracted for a combined analysis. Outcome indicators of the assessment included liver functions and adverse events. Statistical analysis was performed using Review Manager 5.4.

Results: A total of 11 clinical trials met the selection criteria. The pooled analysis' findings demonstrated that both primary and secondary indicators had improved. Compared to the control group, infusion of mesenchymal stem cells significantly increased ALB levels in 2 weeks, 1 month, 3 months, and 6 months, and significantly decreased MELD score in 1 month, 2 months, and 6 months, according to a subgroup analysis using a random-effects model. Additionally, the hepatic arterial injection favored improvements in MELD score and ALB levels. Importantly, none of the included studies indicated any severe adverse effects.

Conclusion: The results showed that mesenchymal stem cell was effective and safe in the treatment of liver cirrhosis, improving liver function (such as a decrease in MELD score and an increase in ALB levels) in patients with liver cirrhosis and exerting protective effects on complications of liver cirrhosis and the incidence of hepatocellular carcinoma. Although the results of the subgroup analysis were informative for the selection of mesenchymal stem cells for clinical treatment, a large number of high-quality randomized controlled trials validations are still needed.

Keywords: Efficacy; Liver cirrhosis; Mesenchymal stem cells; Meta-analysis; Safety.

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Conflict of interest statement

The authors claim that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Literature selection and inclusion process
Fig. 2
Fig. 2
Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies
Fig. 3
Fig. 3
Risk of bias summary: review authors' judgments about each risk of bias item for each included study
Fig. 4
Fig. 4
Forest plot of primary indicator: pooled results of MELD score
Fig. 5
Fig. 5
Forest plot of primary indicator: pooled results of ALB levels before sensitivity analysis
Fig. 6
Fig. 6
Forest plot of primary indicator: pooled results of ALB levels after eliminating heterogeneous
Fig. 7
Fig. 7
Time subgroup of MELD score
Fig. 8
Fig. 8
Forest plot of subgroup in MELD score: Forest plot demonstrating the effect of MSCs compared with controls in subgroup of administration route
Fig. 9
Fig. 9
Time subgroup of ALB levels
Fig. 10
Fig. 10
Administration route subgroup of ALB levels
Fig. 11
Fig. 11
Causes of disease subgroup of ALB levels
Fig. 12
Fig. 12
Dose subgroup of ALB levels
See this image and copyright information in PMC

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