Therapeutic efficacy and safety of umbilical cord mesenchymal stem cell transplantation for liver cirrhosis in Chinese population: A meta-analysis

Background and objective: Mesenchymal stem cells transfusion has been considered as a promising option for liver cirrhosis (LC). The aim of this study was to systematically evaluate the efficacy and safety of umbilical cord mesenchymal stem cells (UMSC) combined with traditional supportive therapy (TST) for the treatment of patients with LC. Methods: Data was extracted from clinical trials published on Web of Science, PubMed, EMBASE, Cochrane Library, Wanfang and CNKI database. The evaluated outcome measurements included liver function, coagulation function, liver fibrosis indexes, clinical symptoms, quality of life (QOL) and adverse events. Results: A total of 14 trials including 717 LC patients met our selection criteria were involved. The liver function of LC patients was significantly improved after combined therapy (UMSC plus TST), indicated by decreased total bilirubin, alanine aminotransferase and prothrombin time, and increased serum albumin, cholinesterase and prothrombin activity. The QOL of patients was also improved after UMSC therapy. Compared with TST alone, the combined therapy showed better treatment effect based on measurements of hyaluronic acid (OR = -143.20, CI = -181.58 to -104.82, P < 0.00001), laminin (OR = -50.65, CI = -53.70 to -47.61, P < 0.00001), type III procollagen (OR = -8.68, CI = -9.00 to -8.36, P < 0.00001), type IV collagen (OR = -105.79, CI = -132.44 to 79.14. P < 0.00001) and plasma prolidase (OR= -876.54, CI = -911.89 to -840.56, P < 0.00001). Moreover, the patients' clinical symptoms including fatigue (4th, P = 0.003; 8th, P = 0.01), appetite (4th, P < 0.0001; 8th, P = 0.06), ascites (4th, P = 0.03; 8th, P = 0.07), and abdominal distension (4th, P = 0.0008; 8th, P = 0.64) were also improved in patients treated by combined therapy without adverse events observed. Conclusion: UMSC and 1ST combined therapy for LC patients improved their liver function, clinical symptoms and QOL without severe adverse events, therefore is safe and effective in LC therapy. (C) 2017 Elsevier Masson SAS. All rights reserved.