Potensi Terapi Mesenchymal Stem Cells (MSCs) Untuk Gagal Hati Kronis Eksaserbasi Akut Akibat Infeksi Virus Hepatitis B: Tinjauan Sistematis dan Meta-analisis Terhadap Studi Uji Acak Terkontrol

Yehuda Tri Nugroho Supranoto, Dini Cynthia Dewi Tanuwijaya

Abstract

Pendahuluan: Gagal hati kronis eksaserbasi akut merupakan dekompensasi penyakit hati kronis yang sering berkaitan dengan infeksi virus hepatitis B (HBV). Terapi Mesenchymal stem cells (MSCs) telah menunjukkan hasil yang menjanjikan untuk meningkatkan fungsi hati secara in vivo. Kajian ini bertujuan untuk menilai potensi MSCs pada pasien dengan gagal hati kronis eksaserbasi akut terkait infeksi HBV.

Metode: Meta-analisis ini dibuat berdasarkan pedoman PRISMA. Pencarian literatur dilakukan dengan beberapa database elektronik, yakni PubMed, ScienceDirect, PMC, Google Scholar, dan Cochrane Library. Risk ratio (RR) dan standardized mean difference (SMD) dengan standar deviasi (SD) digunakan untuk membandingkan risiko mortalitas, skor model for end-stage liver disease (MELD), dan total bilirubin (TBIL) dari pemberian MSCs dan standard medical therapy (SMT).

Hasil: Kajian ini menunjukkan bahwa risiko mortalitas cenderung lebih tinggi pada kelompok SMT (pooled RR= 0.52, 95%CI (0.40,0,69), p<0.00001, I2=0%). Skor MELD juga cenderung lebih tinggi pada kelompok SMT sampai 12 bulan setelah pengobatan (pooled SMD 0.36, 95%CI (0.07, 0.65), p= 0.00002, I2=65%). Perubahan TBIL lebih besar pada kelompok MSCs sampai dengan 4 minggu (pooled SMD= 0.20, 95%CI (-0.11,0.52), p=0.3, I2=16%) dan perubahan TBIL secara keseluruhan sampai 12 bulan menunjukkan adanya perbedaan antara intervensi MSCs dan SMT (pooled SMD= -0.07, 95%CI (-0.23,0.08), p=0.05, I2= 42%).

Kesimpulan: Kajian ini memberikan bukti kuat yang menunjukkan terapi MSCs memiliki potensi yang bermanfaat untuk meningkatkan fungsi hati pada pasien dengan gagal hati kronis eksaserbasi akut terkait infeksi HBV.

Keywords

Gagal hati kronis eksaserbasi akut; Infeksi virus hepatitis B; MSCs; Tinjauan sistematis; Meta-analisis

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References

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DOI: https://doi.org/10.13057/smj.v4i3.54185

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