title: Effects of Granulocyte Colony-Stimulating Factor on Patients with Liver Failure: a Meta-Analysis.
abstract: OBJECTIVE
  It remains controversial whether granulocyte colony-stimulating factor (G-CSF) prolongs survival in liver failure (LF) patients. This meta-analysis was performed to evaluate the effect of G-CSF on patients with LF.
  
  
  METHODS
  PubMed, EMBASE, and Web of Science databases were searched to identify English language randomized controlled trials comparing G-CSF with control therapy published before14 February 2015. A meta-analysis was performed to examine changes in liver function and patient survival. The association was tested using odds ratio (OR) or risk ratio (RR) with 95% confidence intervals (CI).
  
  
  RESULTS
  Five randomized controlled trials were eligible for the meta-analysis. Significant amelioration of prothrombin time and total bilirubin in LF patients was attributed to G-CSF therapy (OR, -0.064; 95% CI,-0.481 to 0.353; p< 0.001; and OR, -0.803; 95% CI, -1.177 to -0.430; p = 0.000, respectively). Treatment with G-CSF resulted in improved Model for End-Stage Liver Disease and Child-Turcotte-Pugh scores (OR, -1.741; 95% CI, -2.234 to -1.250; p = 0.000; and OR, -0.830, 95% CI, -1.194 to -0.465; p = 0.000, respectively). A lower incidence of sepsis was found in patients treated with G-CSF (RR, 0.367; 95% CI, 0.158 to 0.854; p = 0.020). G-CSF therapy significantly increased survival rate in LF patients (RR, 2.25; 95% CI, 1.517 to 3.338; p = 0.000).
  
  
  CONCLUSIONS
  The results of this meta-analysis indicate that G-CSF treatment in patients with LF significantly improved liver function, reduced the incidence of sepsis, and prolonged short-term survival.
authors.affiliation: Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Yang
authors.affiliation: State Key Lab of Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yang
authors.affiliation: State Key Lab of Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Lv
authors.affiliation: Institute of Environmental Medicine, Medical College, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jiliang
authors.initials: J
authors.lastname: He
authors.affiliation: State Key Lab of Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Chen
keywords: Granulocyte colony-stimulating factor; Liver failure; Liver regeneration; Stem cells