Abstract: Objective To systematically review the clinical efficacy and safety of G-CSF (granulocyte colony-stimulating factor) in treatment of patients with hepatic failure. Methods We searched PubMed, WanFang Database, the Cochrane Library, CNKI, CBM, VIP databases to collect RCTs (randomized clinical trials) of G-CSF in treatment of patients with hepatic failure, which were published before January, 2018. RCTs comparing the use of any regimen of G-CSF against placebo or no intervention in patients with ACLF were included. Primary outcomes included overal mortality, mortality due organ failure, and adverse events. We selected the retrieved studies according to the predefined inclusion and exclusion criteria, and evaluated the quality of included studies, a total of 5 studies involving 279 patients with hepatic failure were included. Results The results of meta-analysis showed that the survival rate in G-CSF group was significantly higher than that in control group [RR=1.94,95%CI=1.37-2.26,P<0.0001]. Conclusion G-CSF is more effective than the general supporting treatment for patients with hepatic failure, as it can increase the survival rate and has fewer adverse events. Although the evidence is still limited, the apparent benefit is observed that the use of G-CSF in ACLF patients as a reasonable alternative when liver transplantation is contraindicated or unavailable.

Key words: Granulocyte colony-stimulating factor, hepatic failure, Meta-analysis