Lin Shenglong, Gao Haibing, Ma Huaxi, Liao Ziyuan, Zhang Dongqing, Pan Jinshui, Zhu Yueyong
Department of Severe Hepatopathy, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian Province 350028, China; Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province 350005, China.
Department of Severe Hepatopathy, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian Province 350028, China.
Ann Hepatol. 2024 Sep 16;30(2):101586. doi: 10.1016/j.aohep.2024.101586.
This meta-analysis aims to evaluate the efficacy of stem cell therapy (SCT) for liver failure.
The study adhered to the recommended guidelines of the PRISMA statement. Eligible studies published prior to May 13, 2023, were comprehensively searched in databases including PubMed, Web of Science, and Embase. Quality assessment was conducted using the Cochrane risk-of-bias tool, and the standard mean differences were calculated for the clinical parameters. The hazard ratios were determined by extracting individual patient data from the Kaplan-Meier curve.
A total of 2,937 articles were retrieved, and eight studies were included in the final analysis. Most of the studies focused on HBV-related liver failure and were randomized controlled trials. All studies utilized mesenchymal stem cells (MSCs), with the majority (62.5%) being allogeneic. The analysis revealed that combining stem cell therapy with standard medical treatment or plasma exchange significantly enhanced patient survival and reduced MELD scores. Specifically, allogeneic stem cells showed superior efficacy in improving survival outcomes compared to autologous stem cells. Furthermore, deep vessel injection plus a single injection demonstrated better effectiveness than peripheral vessel injection plus multiple injections in reducing MELD scores.
This comprehensive analysis underscores the potential of MSC therapy in significantly improving survival and clinical outcomes in patients with liver failure, highlighting the superior benefits of allogeneic MSCs and deep vessel plus single injection administration.
本荟萃分析旨在评估干细胞疗法（SCT）治疗肝衰竭的疗效。
本研究遵循PRISMA声明的推荐指南。在包括PubMed、科学网和Embase在内的数据库中全面检索了2023年5月13日前发表的符合条件的研究。使用Cochrane偏倚风险工具进行质量评估，并计算临床参数的标准平均差。通过从Kaplan-Meier曲线中提取个体患者数据来确定风险比。
共检索到2937篇文章，最终纳入8项研究。大多数研究聚焦于乙肝相关肝衰竭，且为随机对照试验。所有研究均使用间充质干细胞（MSCs），其中大多数（62.5%）为同种异体来源。分析显示，将干细胞疗法与标准药物治疗或血浆置换相结合可显著提高患者生存率并降低终末期肝病模型（MELD）评分。具体而言，与自体干细胞相比，同种异体干细胞在改善生存结局方面显示出更高的疗效。此外，在降低MELD评分方面，深部血管注射加单次注射比外周血管注射加多次注射效果更好。
这项综合分析强调了间充质干细胞疗法在显著改善肝衰竭患者生存率和临床结局方面的潜力，突出了同种异体间充质干细胞以及深部血管加单次注射给药的优势。
