A randomised, un-blinded clinical trial of hydrocortisate treatment in acute liver failure was carried out by 17 European centres. During a four year period 40 patients entered the study, 26 in the steroid group and 14 in the control group. The groups were found to be comparable, and the survival was 12 and 14%, respectively. A number of clinical and laboratory data, particularly HBsAg-positivity, appeared to carry some prognostic information, irrespective of treatment, but statistical significance was not achieved. Pooling of the present results with those from relevant published reports indicates a significant negative effect of steroid treatment in acute liver failure (P less than 0.2).
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