This Cochrane review analyzed data from 11 studies involving 681 adults with acute liver failure treated in intensive care units across Europe, India, and the USA. The researchers compared liver support systems, which include artificial or bioartificial liver support, against standard medical care alone. The primary goal was to see if these advanced treatments reduced the risk of dying within 28 days or at the maximum follow-up period. The review also looked at serious adverse events, the need for liver transplantation, and other health outcomes.
The main results suggest that adding liver support systems to standard care may have little to no effect on reducing death by day 28 or at the maximum follow-up. The evidence for serious adverse events also showed little to no difference between the two groups. For the proportion of people needing a liver transplant, the data indicated no significant change. However, the evidence regarding hepatic encephalopathy was very uncertain due to a lack of data.
The certainty of this evidence is very low for all outcomes. This uncertainty stems from risks of bias and imprecision in the results. Additionally, the studies had differences in how they measured mortality, and none included health-related quality of life as a specific outcome. Because the evidence is so limited, readers should be cautious about drawing firm conclusions or changing medical practices based on these findings alone.