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Introduction: Decompensated cirrhosis is an advanced stage of cirrhosis in which liver scarring becomes so extensive that the liver is unable to function properly, leading to complications such as refractory ascites, recurrent infections, and hepatic encephalopathy. Currently, liver transplantation is the only definitive treatment, but it has a number of disadvantages, including high cost, restricted donor pool, and long-term immunosuppression. As a result, granulocyte colony stimulating factor (G-CSF) has emerged as an alternative therapy. However, its clinical efficacy is still debaTable, so the aim of this meta-analysis was to determine the efficacy of G-CSF in patients with cirrhosis. Methods: MEDLINE and SCOPUS were queried from inception till June 2022 for randomized controlled trials (RCTs) without any restrictions. RCTs examining the impact of G-CSF on survival rates in patients with decompensated cirrhosis and compensated cirrhosis were incorporated. The results were reported using a random-effects meta-analysis and the Mantel-Haenszel risk ratio (RR). A P-value of , 0.05 was considered significant for the analysis. The subgroup analysis was performed to investigate the influence of study-level variables such as etiology on outcomes of interest. Results: Eight studies (n 5 8) were included in our meta-analysis. The total number of participants in our study was 712, and the median study duration was 12 months. Our pooled analysis demonstrates that G-CSF treatment significantly improved survival rates (RR 1.29; 95% CI 1.06 to 1.58; p 5 0.01; Figure) in patients with compensated cirrhosis and decompensated cirrhosis. In our subgroup analysis, G-CSF was also linked to higher survival rates among people with decompensated cirrhosis (RR 1.35; 95% CI 1.07 to 1.70; p 5 0.01; Figure ). Conclusion: Our findings indicate that G-CSF treatment is successful in improving the survival rates in patients with decompensated cirrhosis and compensated cirrhosis. Hence, it can be employed as an alternative therapeutic option.

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