Artificial liver support systems: what is new over the last decade?

Annals of Intensive Care

Table 2 Studies with clinical endpoints for AoCLF using MARS

Study	Years	Design	Patients number	Outcomes	Comments	LOE
Hessel et al. [39]	2010	Controlled, randomized MARS + SMT vs. SMT	149	3-year survival improvement*	Acceptable cost-outcome ratio (measured by cost per LYG and costs per QALY)	2
					Inadequate randomization
Novelli et al. [51]	2010	Controlled, non-randomized MARS vs. SMT	20	MELD improvement**	Delta MELD predict survival	2
Bañares et al. [38]	2013	Controlled, randomized, multicentre MARS + SMT vs. SMT	156	No improvement in 28-day and 90-day transplant-free survivals	No differences in 28-day transplant-free survival in subgroups: MELD > 20, HRS at admission, severe HE, and progressive hyperbilirubinemia	1
Gerth et al. [40]	2017	Controlled, non-randomized MARS + SMT vs. SMT	101	Improvement in 7-day and 14-day* transplant-free survivals	No differences in 21-day and 28-day transplant-free survivals	2
					Improvement in estimate 28-day transplant-free survival rate in subgroup of patients with two or more organs failure (CLIF-ACLF grade ≥ 2)*

LOE level of evidence, determined using the strength of recommendation taxonomy (SORT) criteria [50], SMT standard medical therapy, LYG life years gained, QALY quality-adjusted life years, MELD model for end-stage liver disease, HRS hepatorenal syndrome, HE hepatic encephalopathy, CLIF-ACLF chronic liver failure-acute-on-chronic liver failure
*logrank p < 0.05
**p < 0.01
***p < 0.05