Patel, Christine Bernsmeier, Jennifer M. Ryan, Laura J. Blackmore, Xiaohong Huang, Victoria T. Kronsten, Nicholas J. Taylor, Georg Auzinger, Christopher Willars, Yun Ma, Barbara Bain, Alice Warley Background: Acute-on-chronic liver failure (ACLF) is associated with increased short and long-term mortality. Currently, orthotropic
liver transplantation remains the only definitive therapy for patients with ACLF. Several animal models of liver failure have demonstrated that granulocytecolony Rucaparib stimulating factor (G-CSF) accelerates the liver regeneration process and improves survival. The objective of this systematic review was to assess the benefits and harms of G-CSF in patients with acute-on-chronic liver failure. Material and methods: The research
was made in The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS until November 2013. Additionally, the references from the identified studies were handsearched. Randomized clinical trials comparing the use of G-CSF against placebo or no intervention in patients with ACLF were selected. Three authors independently assessed the quality of the studies, evaluated the risk of bias, and extracted the data. Results: Two trials with a total of 102 patients were included. One trial compared the use of G-CSF against Selleckchem SB525334 placebo. The second trial compared G-CSF against no intervention. Compared with the control group, the group that received G-CSF presented a significant reduction in short-term mortality (RR 0.56; 95% CI 0.39 to 0.80). There is not enough evidence PAK5 to show an effect of G-CSF therapy on mortality secondary to gastrointestinal bleeding (RR 1.45; 95% CI 0.50 to 4.27). The adverse effects reported included: fever, rash, zoster, headache and nausea. Conclusions: The use of G-CSF for the treatment of patients with ACLF significantly reduced short-term mortality. Forest Plot: G-CSF vs. placebo or no intervention: all cause mortality Disclosures: The following people have nothing
to disclose: Victoria J. Ornelas-Arroyo, Desiree Vidaña-Pérez, Guadalupe Delgado-Sánchez, Indira R. Mendiola Pastrana, Camilo Noreña-Herrera, Tonatiuh Barrientos-Gutierrez, Eva Juárez Hernández, Nahum Méndez-Sanchéz, Misael N. Uribe-Esquivel, Norberto C. Chavez-Tapia [Aims] Novel diagnostic criteria for “acute liver failure (ALF)” were established in 2011 in Japan, which include the disease entity of “fulminant hepatitis”. Based on these, a nationwide survey was executed to clarify the etiology, clinical features and outcome of ALF patients seen between 2010 and 2012. [Methods] Total of 757 ALF patients were enrolled from 742 institutes. All patients showed a prothrombin time (INR) of 1.5 or more within 8 weeks after the onset of deaese symptoms. [Results] (1) Disease Types: 757 patients were classified into 385 patients (50.9%) without hepatic coma and 372 patients (49.