Table 1.
Randomized controlled trials included in the systematic review and network metaanalysis.
| Study | Country | Population | Aetiology | Intervention (No of patients) | No of sessions | Ancillary hemodialysis (HD) and use of anticoagulant (AC) therapy |
Comparator (No of patients) | Age range (mean) | Women (%) |
|---|---|---|---|---|---|---|---|---|---|
| Redeker (1973) | USA | ALF with gr. IV HE | Acute viral hepatitis (100%) | Exchange transfusion (n = 15) | Mean, SD: 1,1 ± 0.35, median: 1, range: 1–2, max: 2 | AC: received | Standard medical therapy (n = 13) | 16–67 (25.1) | 39 |
| O'Grady (1988) | UK | FHF with gr. IV HE | Acetaminophen overdose (AO) (52%), viral hepatitis (40%) drug reaction (8%) | Charcoal hemoperfusion (n = 29) | Median: 2, max: 4 |
HD: at the physician’s discretion AC: received |
Standard medical therapy (n = 33) | ||
| Hughes (1994) | UK | FHF with gr. IV HE | AO (60%), viral hepatitis (40%) | BioLogic-DT (n = 5) | Mean: 3.6, median: 4, range: 2–5, max: 5 |
HD: in case of renal failure, patients were excluded AC: not applied (producer’s suggestion) |
Standard medical therapy (n = 5) | 19–64 (37.3) | 30 |
| Ellis (1996) | UK | ALF | AO (71%), viral hepatitis (21%), drug induced (8%) | ELAD (n = 12) | Continuous | HD: at the physician’s discretion | Standard medical therapy (n = 12) | 14–65 | 50 |
| Mazariegos (1997) | USA | ALF with coma | BioLogic-DT (n = 5) | Max. 5 | Standard medical therapy (n = 1) | 35–65 (48.3) | 67 | ||
| Wilkinson (1998) | USA | ALF with gr. III-IV HE | Viral hepatitis (66%) heat stroke (33%) | BioLogic-DT (n = 1) | Mean: 3.6, max: 5 |
HD: in case of renal failure, patients were excluded AC: not applied (producer’s suggestion) |
Standard medical therapy (n = 2) | 27–58 (42.7) | 33 |
| Ellis (1999) | UK | ALF with gr. II or greater HE | Acute alcoholic hepatitis (100%) | BioLogic-DT (n = 5) | Mean: 2.6, median: 3, range: 1–3, max: 3 |
HD: at the physician’s discretion AC: received |
Standard medical therapy (n = 5) | 36–64 | 30 |
| Demetriou (2004) | USA and Europe | FHF/SHF with gr. III-IV HE, PNF | Viral hepatitis + AO + other drug induced (49%) indeterminate (37%), PNF (14%) | HepatAssist (n = 85) | Mean: 2.9, range: 1–9 | Standard medical therapy (n = 86) | 10–69 (37) | 70 | |
| Pollock (2004) | UK | FHF | AO (100%) | MARS (n = 6) | Max. 14 | Standard medical therapy (n = 6) | |||
| El Banayosi (2007) | Germany | ALF | Cardiogenic shock after cardiac surgery (100%) | MARS (n = 20) | Range: 1–54 | Standard medical therapy (n = 20) | 28 | ||
| Saliba (2013) | France | ALF | AO (38%), viral hepatitis 14%) autoimmune hepatitis (12%), mushroom induced (8%), unknown (8%), drug reaction (6%), toxic agents (6%), other (9%) | MARS (n = 53) | Median: 1, range: 0–7 | HD: at the physician’s discretion | Standard medical therapy (n = 49) | (40.4) | 57 |
| Larsen (2016) | Denmark, UK, Finland | ALF with gr. II or greater HE | AO (59%), unknown (21%), toxic agents (9%), viral hepatitis 6%), Budd-Chiari syndrome (1%), other (3%) | High-volume plasma exchange (n = 92) | Mean, SD: 2.4 ± 0,8, max: 3 |
HD: at the physician’s discretion AC: received based on local guidelines |
Standard medical therapy (n = 90) | 33–56 | 68 |
Table contains study characteristics of the included trials. Blank cells indicate that the data were not reported in the article. Abbreviations: ALF: acute liver failure, HE: hepatic encephalopathy, HD: hemodialysis, AC: anticoagulant, SD: standard deviation, max: maximum, USA: United States of America, FHF: fulminant hepatic failure, gr.: grade, UK: United Kingdom, AO: acetaminophen overdose, SHF: subfulminant hepatic failure, PNF: primary nonfunction following liver transplantation.