Abstract
A systematic review and meta-analysis were performed to explore the clinical outcome of the transplantation of stem cells from various human tissue sources in cirrhotic patients. The relevant papers were searched via PubMed, EMBASE, and Cochrane Library databases. Changes in liver function before and after stem cell therapy were evaluated (self-control data). Difference in liver function and incidence of procedure-related complications, hepatocellular carcinoma (HCC), and death between patients undergoing stem cell therapy and conventional treatment were evaluated (case-control data). Of 786 papers initially identified, 31 were included. The sources of stem cell included bone marrow (n=26), umbilical cord (n=3), peripheral blood (n=1), and human fetal liver (n=1). No severe procedure-related complications were reported. According to the meta- analyses of self-control data, model for end-stage liver diseases (MELD) score was significantly reduced at the 3rd-4th and 6th months after stem cell therapy, but this reduction was not statistically significant at the 1st-2nd or 12th postoperative months. Child-Pugh score was also reduced after stem cell therapy, but the reduction was not statistically significant at all follow-up time points. According to the meta-analyses of case-control data, MELD and Child-Pugh scores were not significantly different between treatment and control groups at all follow-up time points. The incidence of HCC was not significantly different between treatment and control groups (odds ratio [OR] to=0.41, P=0.53). The mortality was not significantly different between the two groups (OR=0.48, P=0.20). Stem cell therapy could improve the liver function without any severe procedure-related complications. However, compared with conventional treatment, the benefit of stem cell therapy appeared to be not significant in improving the liver function and survival.
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