Korean J Intern Med.  2012 Mar;27(1):13-19. 10.3904/kjim.2012.27.1.13.

Albumin for End-Stage Liver Disease

• Lee JS

• KMID: 1776560
• DOI: http://doi.org/10.3904/kjim.2012.27.1.13

Abstract

Albumin has been widely used in patients with cirrhosis in an attempt to improve circulatory and renal functions. The benefits of albumin infusions in preventing the deterioration in renal function associated with large-volume paracentesis, spontaneous bacterial peritonitis, and established hepatorenal syndrome in conjunction with a vasoconstrictor are well established. While some of these indications are supported by the results of randomized studies, others are based only on clinical experience and have not been proved in prospective studies. The paucity of well-designed trials, the high cost of albumin, the lack of a clear-cut survival benefit, and fear of transmitting unknown infections make the use of albumin controversial. The recent development of the molecular adsorbent recirculating system, an albumin dialysis, is an example of the capacity of albumin to act by mechanisms other than its oncotic effect. Efforts should be made to define the indications for albumin use, the dose required, and predictors of response, so that patients gain the maximum benefit from its administration.

Keyword

Albumins; Liver cirrhosis; Ascites; Peritonitis; Hepatorenal syndrome; Encephalopathy

MeSH Terms

Albumins/*administration & dosage/adverse effects
Ascites/therapy
End Stage Liver Disease/physiopathology/*therapy
Evidence-Based Medicine
Hepatorenal Syndrome/therapy
Humans
Liver Cirrhosis/therapy
Plasma Substitutes/*administration & dosage/adverse effects
Sorption Detoxification/adverse effects/*methods
Treatment Outcome