Transplant Trial Watch

Factors improving mortality in critically ill patients with liver failure - A systematic review.

Kovacs, E., et al.

Physiology International 2023; 110(3): 211-226.

The aim of this study was to identify all randomised controlled trials that showed a statistically significant effect of an intervention in reducing mortality in patients with hepatic failure.

A literature search was conducted in three databases including PubMed, Scopus and Embase. Study selection and data extraction were performed by two independent reviewers.

9 studies were included in the review.

The main outcome of interest included statistically significant differences in mortality between the intervention and control groups.


CET Conclusions
This systematic literature review aimed to provide an overview of all randomized controlled trials in which the intervention was observed to have a statistically significantly effect in reducing mortality in critically ill patients with acute liver failure (ALF) or cirrhosis. Four independent reviewers were involved in the selection of eligible studies and data extraction. Nine RCTs were included in the review. However, the methodological quality of the included studies was not assessed. The authors found that antibiotic therapy was effective in reducing mortality among cirrhotic patients requiring hospitalization or ICU treatment. Tacrolimus administration following liver transplantation, albumin, HVP exchange and N-acetylcysteine were also associated with mortality reduction in specific aspects of hepatic failure during hospitalization and ICU therapy. Additionally, a positive effect of terlipressin in cirrhotic patients with sepsis was also observed.

Trial registration

Funding source
Not reported