title: Autologous bone marrow transplantation in decompensated liver: Systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy of autologous bone marrow mononuclear cell transplantation in decompensated liver disease.
  
  
  METHODS
  Medline, EMBASE, PubMed, Science Direct, and the Cochrane Library were searched for relevant studies. Retrospective case-control studies were included along with randomized clinical trials. Meta-analysis was performed in line with recommendations from the Cochrane Collaboration software review manager. Heterogeneity was assessed using a random-effects model.
  
  
  RESULTS
  Four randomized controlled trials and four retrospective studies were included. Cell transplantation increased serum albumin level by 1.96 g/L (95%CI: 0.74-3.17; P = 0.002], 2.55 g/L (95%CI: 0.32-4.79; P = 0.03), and 3.65 g/L (95%CI: 0.76-6.54; P = 0.01) after 1, 3, and 6 mo, respectively. Patients who had undergone cell transplantation also had a lower level of total bilirubin [mean difference (MD): -1.37 mg/dL; 95%CI: -2.68-(-0.06); P = 0.04] after 6 mo. This decreased after 1 year when compared to standard treatment (MD: -1.26; 95%CI: -2.48-(-0.03); P = 0.04]. A temporary decrease in alanine transaminase and aspartate transaminase were significant in the cell transplantation group. However, after 6 mo treatment, patients who had undergone cell transplantation had a slightly longer prothrombin time (MD: 5.66 s, 95%CI: 0.04-11.28; P = 0.05). Changes in the model for end-stage liver disease score and Child-Pugh score were not statistically significant.
  
  
  CONCLUSIONS
  Autologous bone marrow transplantation showed some benefits in patients with decompensated liver disease. However, further studies are still needed to verify its role in clinical treatment for end-stage liver disease.
authors.affiliation: Prasoon Pankaj, Qi Zhang, Xue-Li Bai, Ting-Bo Liang, Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Prasoon
authors.initials: P
authors.lastname: Pankaj
authors.affiliation: Prasoon Pankaj, Qi Zhang, Xue-Li Bai, Ting-Bo Liang, Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Prasoon Pankaj, Qi Zhang, Xue-Li Bai, Ting-Bo Liang, Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Xue-Li
authors.initials: XL
authors.lastname: Bai
authors.affiliation: Prasoon Pankaj, Qi Zhang, Xue-Li Bai, Ting-Bo Liang, Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Ting-Bo
authors.initials: TB
authors.lastname: Liang
mesh_terms: D015415:Biomarkers / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D016009:Chi-Square Distribution; D058625:End Stage Liver Disease / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008111:Liver Function Tests; D016017:Odds Ratio; D012307:Risk Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Autologous transplantation; Bone marrow; Cirrhosis; Decompensated liver disease