Randomized controlled trials involving liver failure.

The study was conducted to analyze and summarize evidence from recent randomized controlled trials (RCTs) investigating liver failure. A MEDLINE search was performed to identify prospective RCTs in liver failure published after 1996. Eligible RCTs were analyzed based on various items including publication year, geographical area, and study theme. Sixty-two papers were eligible for review. One to 9 RCTs have been performed annually. Geographically, 41 trials were performed in Europe, 11 trials in Asia and 10 trials in North America. Studies concerning hepatic encephalopathy have been most frequent (26 papers). RCTs involving esophageal variceal bleeding (17 papers) and RCTs examining the treatment of acute liver failure, including artificial liver (13 papers), follow in descending order. This study reviewed 62 RCTs investigating liver failure during the last decade. Concerning variceal bleeding, ascites, and nutritional supplementation, therapeutic consensus seems to have been established. In contrast, there has been little significant evidence with regard to artificial liver.