Effects of Branched-Chain Amino Acids on Patients Undergoing Hepatic Intervention: A Meta-Analysis of Randomized Controlled Trials

Abstract

Abstract BACKGROUND: The benefits of branched-chain amino acid (BCAA) administration after hepatic intervention in patients with liver diseases remains unclear. We conducted a systematic review and meta-analysis to evaluate the effects of BCAA on patients undergoing hepatectomy, trans-arterial embolization, radiofrequency ablation. METHODS: Relevant randomized controlled trials (RCTs) were obtained from PubMed, EMBASE, and Cochrane Library databases. A meta-analysis was performed to calculate the pooled effect size by using random-effects models. The primary outcomes were survival, hospital stay, nutrition status, and biochemistry profile. The secondary outcomes were the complication rate of liver treatment and adverse effect of BCAA supplementation. RESULTS: In total, 11 RCTs involving 750 patients were included. Our meta-analysis showed no significant difference in the rates of tumorrecurrence and overall survival between the BCAA and control groups. However, the pooled estimate showed that BCAA supplementation in patients undergoing hepatic intervention significantly increased serum albumin (mean difference [MD]: 0.11 g/dL, 95% confidence interval [CI]: 0.02–0.20) at 6 months and cholinesterase level (MD: 50.00 U/L, 95% CI: 21.08–78.92) at 12 months, increased body weight (MD: 3.29 kg, 95% CI: 1.07–5.50) at 12 months, and reduced ascites incidence (risk ratio: 0.39, 95% CI: 0.21–0.71) compared with the control group. Additionally, BCAA administration shortened the hospital stay length (MD: −2.36 days, 95% CI: −4.78 to 0.07) compared with the control group. CONCLUSION: BCAA supplementation significantly reduced postintervention complication and hospitalization duration and increased body weight. Thus, BCAA supplementation may benefit patients undergoing liver intervention.