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Table 3 Studies with clinical endpoints for ALF and AoCLF combined using MARS

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

Study

Years

Design

Patients number

Outcomes

Comments

LOE

Rusu et al. [59]

2009

Uncontrolled, retrospective

27

Improvement in HE in ALF**

Haemodynamic improvement in patients with liver failure post-transplantation**

3

    

No clinical improvement in AoCLF

  

Stutchfield et al. [54]

2011

Systematic review

8 RCT

ELS improved survival in ALF**

Independent meta-analysis for trials including patients with ALF or AoCLF

2

    

No statistically significant reduction in mortality in AoCLF

3 trials using bioartificial devices included

 

Vaid et al. [52]

2012

Meta-analysis

9 RCT

1 NRS

Improvement in HE*

No significant differences in subgroups (by age or MARS number sessions)

2

    

No statistically significant reduction in overall mortality

Safety data no meta-analyzed

 

Cisneros-Garza et al. [60]

2014

Uncontrolled, retrospective

70

Improvement in HE*

Patients with cholestasis disease were included. MARS associated with improved itching

3

Tsipotis et al. [53]

2015

Meta-analysis

10 RCT

Improvement in HE*

No significant differences in subgroups (by number of sessions or type of albumin dialysis technique)

2

    

No statistically significant reduction in overall mortality

3 trials used Prometheus

 

Guo-Lin He et al. [55]

2015

Systematic review

10 RCT

Reduction in mortality in ALF**

Independent meta-analysis for trials including patients with ALF or AoCLF

 
    

No statistically significant reduction in mortality in AoCLF

Very few patients with ALF included

2

  1. LOE level of evidence, determined using the strength of recommendation taxonomy (SORT) criteria [50], HE hepatic encephalopathy, RCT randomized controlled trial, ELS extracorporeal liver support, NRS non-randomized controlled study
  2. *p < 0.01
  3. **p < 0.05