The Optimal Therapeutic Window for Nonbioartificial Liver Support in Acute-On-Chronic Liver Failure: A Meta-Analysis and Meta-Regression Based on Baseline MELD Score.
J Clin ApherSep 16, 2026
Clinical ResearchGastroenterology
Jiahao Li, Yang Liu, Jianying Shao et al.
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In 30 seconds
This meta-analysis evaluated the efficacy of nonbioartificial liver support (NBALS) in patients with acute-on-chronic liver failure (ACLF), focusing on baseline MELD scores. Analyzing 11 studies with 1958 patients, the results indicated that NBALS significantly reduced 28-day mortality compared to standard medical therapy (pooled RR 0.72, 95% CI [0.63-0.83]). The most pronounced survival benefit was observed in patients with MELD scores between 25 and 30.
Key findings
- NBALS reduced 28-day mortality compared to standard medical therapy (pooled RR 0.72, 95% CI [0.63-0.83]).
- The survival benefit was most significant in the Intermediate MELD group (RR 0.65, 95% CI [0.52-0.81]).
- NBALS achieved a greater reduction in total bilirubin compared to standard medical therapy (pooled MD 98.15, 95% CI [66.50-129.79]).
- Meta-regression indicated maximum survival benefit of NBALS within a MELD range of approximately 25 to 32.
Why it matters
Understanding the optimal therapeutic window for NBALS in ACLF can guide clinicians in selecting appropriate patients for this intervention, potentially improving short-term survival outcomes.