title: Bone marrow-derived mesenchymal stem cell therapy for decompensated liver cirrhosis: a meta-analysis.
abstract: OBJECTIVE
  To assess the efficacy and safety of bone marrow-derived mesenchymal stem cell (BM-MSC) in the treatment of decompensated liver cirrhosis.
  
  
  METHODS
  The search terms "bone marrow stem cell" "chronic liver disease" "transfusion" and "injection" were used in the Cochrane Library, Med-Line (Pub-Med) and Embase without any limitations with respect to publication date or language. Journals were also hand-searched and experts in the field were contacted. The studies which used BM-MSC in the treatment of any chronic liver disease were included. Comprehensive Review Manager and Meta-Analyst software were used for statistical analysis. Publication bias was evaluated using Begg's test.
  
  
  RESULTS
  Out of 78 studies identified, five studies were included in the final analysis. The studies were conducted in China, Iran, Egypt and Brazil. Analysis of pooled data of two controlled studies by Review Manager showed that the mean decline in scores for the model for end-stage liver disease (MELD) was -1.23 [95%CI: -2.45-(-0.01)], -1.87 [95%CI: -3.16-(-0.58)], -2.01 [95%CI: -3.35-(-0.68)] at 2, 4 and 24 wk, respectively after transfusion. Meta-analysis of the 5 studies showed that the mean improvement in albumin levels was -0.28, 2.60, 5.28, 4.39 g/L at the end of 8, 16, 24, and 48 wk, respectively, after transfusion. MELD scores, alanine aminotransferase, total bilirubin levels and prothrombin times improved to some extent. BM-MSC injections resulted in no serious adverse events or complications.
  
  
  CONCLUSIONS
  BM-MSC infusion in the treatment of decompensated liver cirrhosis improved liver function. At the end of year 1, there were no serious side effects or complications.
authors.affiliation: Xing-Nan Pan, Lian-Qiu Zheng, Xiao-Huan Lai, Clinical Liver Center, 180 Hospital of People's Liberation Army, Quanzhou 362000, Fujian Province, China.
authors.forename: Xing-Nan
authors.initials: XN
authors.lastname: Pan
authors.affiliation: Xing-Nan Pan, Lian-Qiu Zheng, Xiao-Huan Lai, Clinical Liver Center, 180 Hospital of People's Liberation Army, Quanzhou 362000, Fujian Province, China.
authors.forename: Lian-Qiu
authors.initials: LQ
authors.lastname: Zheng
authors.affiliation: Xing-Nan Pan, Lian-Qiu Zheng, Xiao-Huan Lai, Clinical Liver Center, 180 Hospital of People's Liberation Army, Quanzhou 362000, Fujian Province, China.
authors.forename: Xiao-Huan
authors.initials: XH
authors.lastname: Lai
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects; D016009:Chi-Square Distribution; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008111:Liver Function Tests; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects; D016017:Odds Ratio; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bone marrow stem cell; Decompensated liver cirrhosis; Meta-analysis; Transfusion