Bone marrow-derived mesenchymal stem cell therapy for decompensated liver cirrhosis: A meta-analysis

Table 1 Characteristics of the included studies

Ref.	Year	Country	Assessment of purity	Type of infused cells and volume	Infused cells (n)	Patients and disease etiology (n)	Frequency of stem cell transfusions	The route of transfusion
Peng et al[19]	2011	China	Flow cytometry	BMNCs (MSCs) from iliac crest (120 mL)	NA	6 HBV + 15ctrl. after 48 wk follow-up	Once	Hepatic artery
Mohamadnejad et al[20]	2007	Iran	Fluorescence-assisted cell sorting flowcytometry	Cultured bone marrow-derived MSCs (80-100 mL)	31.7 × 106 (mean)	3 Cryptogenic, 1 AIH	Once	Cubital vein of the arm over 30 min
Mohamadnejad et al[21]	2007	Iran	FACS Calibur flow cytometer	Bone marrow-derived CD34+ Cells from iliac crest (200 mL)	5.25 × 106 (mean)	1 HBV, 1 PBC, 1 AIH1, 1 cryptogenic	Once	Hepatic artery
Amer et al[18]	2010	Egypt	Immunophenotyping	Cultured bone-marrow derived MSCs stimulated to hepatic lineage using HGF-containing medium (95 ± 25 mL)	2 × 108	20 HCV + 20 ctrl	Once	Intrasplenic or intrahepatic
Lyra et al[22]	2007	Brazil	NA	BMNCs (MSCs) from iliac crest (maximum 50 mL)	1 × 108	10 NA	Once	Hepatic artery

¹This patient developed progressive renal failure, and went on to develop type 1 hepatorenal syndrome and died of liver failure. MSCs: Mesenchymal stem cells; FACS: Florescence-assisted cell sorting; NA: Not available; HBV: Hepatitis B virus; AIH: Autoimmune liver disease; PBC: Primary biliary cirrhosis; HCV: Hepatitis C virus.

Table 2 Albumin, total bilirubin, prothrombin times, and model for end-stage liver disease values during follow-up

Time point	Studies (n)	Cases (n)	Type of model	I2	P value	Estimate	95%CI
Change from baseline of albumin levels (g/L)
8 wk	2	9	RE	0.000	0.969	-0.28	-3.31-2.85
16 wk	2	13	RE	0.000	0.995	2.60	-0.35-5.56
24 wk	3	13	RE	0.413	0.185	5.28	1.81-8.75
48 wk	2	14	RE	0.831	0.015	4.39	-1.62-10.40
Change from baseline of ALT levels (IU/L)
4 wk	2	16	RE	0.667	0.083	-16.33	-50.71-18.06
24 wk	3	13	RE	0.647	0.059	-7.04	-33.99-19.91
48 wk	2	10	RE	0.333	0.221	-18.18	-44.03-7.06
Change from baseline of TBIL levels
4 wk	2	16	RE	0.948	0.000	-69.34	-191.12-53.45
24 wk	3	13	RE	0.945	0.000	-47.21	-130.18-35.76
48 wk	2	10	RE	0.966	0.000	-86.17	-254.53-82.19
Change from baseline of PT values (s)
24 wk	3	13	RE	0.843	0.002	-4.77	-9.22--0.33
48 wk	2	10	RE	0.931	0.000	-5.88	-13.42-1.65
Change from baseline MELD scores
2 wk	2	26	RE	0.977	0.000	-3.27	-8.84-2.30
4 wk	2	26	RE	0.994	0.000	-6.28	-17.86-5.29
8 wk	2	23	RE	0.606	0.111	-1.43	-4.92-2.06
16 wk	2	23	RE	0.000	0.644	0.31	-0.67-1.30
24 wk	4	33	RE	0.982	0.000	-4.28	-13.39-4.83
48 wk	2	10	RE	0.948	0.000	-7.62	-16.86-1.63

PT: Prothrombin times; MELD: Model for end-stage liver disease; TBIL: Total bilirubin; ALT: Alanine aminotransferase; RE: Random effects.