THU-272-A study investigating the effect of extracorporeal cellular therapy with C3A cells on the survival of alcoholic hepatitis designed along the guidelines of the NIAAA

Pyrsopoulos, Nikolaos; Hassanein, Tarek; Subramanian, Ram; Thompson, J. Stephen; Caldwell, Stephen H.; Al-Khafaji, Ali; Reich, David J.; Sieberhagen, Cyril; Stange, Jan

doi:10.1016/s0618-8278(19)30539-0

Cited by 6 publications

(5 citation statements)

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“…Long-term survival was assessed in six studies. Six-month survival was reported to be identical in both groups by Hassanein, Heemann, and Pyrsopoulos (additionally presented at a conference, together with 1-year survival) [31,38,42]. Duan et al reported higher transplant-free survival in the ELAD group, maintained until the end of the 5-year follow-up [40].…”

Section: Synthesis Survivalmentioning

confidence: 88%

“…The main characteristics of the 23 eligible studies included in qualitative synthesis are shown in Table 1. Of the 16 studies, enrolling 1670 patients included in the meta-analysis, 15 compared a type of artificial [29][30][31][32][33][34][35][36][37][38] or bioartificial [39][40][41][42][43] liver support system to standard medical therapy and one study compared MARS versus MARS plus plasma exchange [44]. The most common etiologies of underlying diseases were viral infection and alcohol.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

Ocskay

Kanjo

Gede

et al. 2021

Ann. Intensive Care

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Background The role of artificial and bioartificial liver support systems in acute-on-chronic liver failure (ACLF) is still controversial. We aimed to perform the first network meta-analysis comparing and ranking different liver support systems and standard medical therapy (SMT) in patients with ACLF. Methods The study protocol was registered with PROSPERO (CRD42020155850). A systematic search was conducted in five databases. We conducted a Bayesian network meta-analysis of randomized controlled trials assessing the effect of artificial or bioartificial liver support systems on survival in patients with ACLF. Ranking was performed by calculating the surface under cumulative ranking (SUCRA) curve values. The RoB2 tool and a modified GRADE approach were used for the assessment of the risk of bias and quality of evidence (QE). Results In the quantitative synthesis 16 trials were included, using MARS®, Prometheus®, ELAD®, plasma exchange (PE) and BioLogic-DT®. Overall (OS) and transplant-free (TFS) survival were assessed at 1 and 3 months. PE significantly improved 3-month OS compared to SMT (RR 0.74, CrI: 0.6–0.94) and ranked first on the cumulative ranking curves for both OS outcomes (SUCRA: 86% at 3 months; 77% at 1 month) and 3-month TFS (SUCRA: 87%) and second after ELAD for 1-month TFS (SUCRA: 76%). Other comparisons did not reach statistical significance. QE was moderate for PE concerning 1-month OS and both TFS outcomes. Other results were of very low certainty. Conclusion PE seems to be the best currently available liver support therapy in ACLF regarding 3-month OS. Based on the low QE, randomized trials are needed to confirm our findings for already existing options and to introduce new devices.

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Section: Synthesis Survivalmentioning

confidence: 88%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

Ocskay

Kanjo

Gede

et al. 2021

Ann. Intensive Care

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“…This led to a more recent clinical trial (VTI-308) that compared ELAD+SOC vs. SOC treatment in a more select population of patients with AH (n = 151). 127 Again, no benefit was shown for survival; mortality at 90 days was comparable (ELAD 19.2% vs. SOC 21.9%; p = 0.68). The company stopped the development of the device.…”

Section: Bioartificial Liver Cell Therapymentioning

confidence: 88%

Intensive care management of acute-on-chronic liver failure

Bernal

Karvellas

Saliba

et al. 2021

Journal of Hepatology

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The syndrome of acute-on-chronic liver failure combines deterioration of liver function in a patient with chronic liver disease, with the development of extrahepatic organ failure and high short-term mortality. Its successful management demands a rapid and coherent response to the development of dysfunction and failure of multiple organ systems in an intensive care unit setting. This response recognises the features that distinguish it from other critical illness and addresses the complex interplay between the precipitating insult, the many organ systems involved and the disordered physiology of underlying chronic liver disease. An evidence base is building to support the approaches currently adopted and outcomes for patients with this condition are improving, but mortality remains unacceptably high. Herein, we review practical considerations in critical care management, as well as discussing key knowledge gaps and areas of controversy that require further focussed research.

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“…A subsequent evaluation targeting AH patients with more specific patient demographics (n = 151) found no significant survival benefit: the 90-day mortality rate was 19.2% for ELAD+SOC and 21.9% for SOC alone (p = 0.68). (available only as an abstract) [108].…”

Section: The Dynamics Of Coagulation In Patients With Aclfmentioning

confidence: 99%

Navigating the Labyrinth: Intensive Care Challenges for Patients with Acute-on-Chronic Liver Failure

Saner,

Raptis,

Alghamdi

et al. 2024

JCM

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Acute-on-chronic liver failure (ACLF) refers to the deterioration of liver function in individuals who already have chronic liver disease. In the setting of ACLF, liver damage leads to the failure of other organs and is associated with increased short-term mortality. Optimal medical management of patients with ACLF requires implementing complex treatment strategies, often in an intensive care unit (ICU). Failure of organs other than the liver distinguishes ACLF from other critical illnesses. Although there is growing evidence supporting the current approach to ACLF management, the mortality associated with this condition remains unacceptably high. In this review, we discuss considerations for ICU care of patients with ACLF and highlight areas for further research.

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THU-272-A study investigating the effect of extracorporeal cellular therapy with C3A cells on the survival of alcoholic hepatitis designed along the guidelines of the NIAAA

Cited by 6 publications

References 0 publications

Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

Intensive care management of acute-on-chronic liver failure

Navigating the Labyrinth: Intensive Care Challenges for Patients with Acute-on-Chronic Liver Failure

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