Branched Chain Amino Acids in Improving Survival and Decreasing Risk of Liver Failure among Cirrhotic Patients: A Meta-Analysis H. Flores 1 , E.L. Ang 1 , N. IV Estanislao 1 1 Philippine General Hospital Background: The state of a patient's nutritional status greatly affects disease outcome. Among cirrhotic patients, approximately 60-90% are in a state of protein-energy malnutrition. Hence, adequate nutritional support is essential to improve their general medical condition and long term prognosis. Several studies have shown than branched chain amino acids (BCAA) may be of benefit for this purpose. It is the aim of this study to evaluate the effectiveness of diet plus BCAA compared to diet alone in improving survival and in decreasing liver failure among cirrhotic patients. Methods: Pubmed, Cochrane, and EMBASE search was done for articles which compared the clinical effects of BCAA supplementation versus diet alone among patients with liver cirrhosis. The following free-text terms and MESH words were used -"Branched chain amino acids", "amino acids, branched chain", "BCAA", "liver cirrhosis", "cirrhosis", "Randomized Controlled Trials'" and "Meta-analysis". After critical appraisal of the included studies, a random effects model using odds ratio was used to synthesize the results (RevMan 4.2). Results: 3 RCTs were included for analysis with a total study population of 836. Combination of the studies showed a significant decrease in the risk of liver failure (OR 0.45, 95% CI 0.25-0.82, p=0.009) and a trend towards benefit in improving survival (OR 0.57, 95% CI 0.27-1.17, p=0.12). Conclusions: The overall trend appears to show benefit in the use of Branched Chain Amino Acids for patients with cirrhosis with respect to liver failure and survival.