Albumin treatment improves overall survival for decompensated cirrhosis patients

Patients with cirrhosis who were treated with human albumin experienced improvement in a number of outcomes, including overall survival, compared to standard therapy, according to data presented at the International Liver Congress.

“Long-term albumin administration to patients with decompensated cirrhosis could be seen as a disease-modifying treatment,” Mauro Bernardi, MD, of the University of Bologna, in Italy, said in a press conference. “At the moment, the only curative approach is transplant. Treatment to influence the survival of these patients is most needed.”


In the current study, all participants received anti-mineralocorticoid at 200 mg per day plus furosemide at 25 mg per day. Those in the treatment group were given human albumin at 40 g twice a week for 2 weeks, then 40 g per week. Patients were followed monthly for 18 months unless they underwent transplantation or transjugular intrahepatic portosystemic shunt (TIPS).

The primary endpoint was OS. Parameters including cumulative number of paracentesis, ascites incidence, bacterial infections, renal dysfunction, HRS type 1, hepatic encephalopathy, portal hypertensive gastrointestinal bleeding, hospital admission and QOL comprised the secondary outcomes.

OS rates were 78% for the albumin group and 66% for the standard therapy group (HR = 0.62; 95% CI, 0.40-0.95). “Mortality was reduced by 38% in the human albumin group,” Bernardi said.

Paracentesis rates were 38% in the albumin arm and 66% in the standard therapy arm (IR = 3.50; 95% CI, 0.40-0.53), representing a reduction of 54% (P < .0001).

Other findings indicated that albumin reduced hospital stay duration by 19.4 days per year, representing a 45% reduction compared with standard therapy (P < .0001).

He concluded that this approach aids in managing ascites and improves both survival and QOL. “It reduces the incidence of severe complications of cirrhosis and reduces the number of hospitalizations,” he said. “It is generally well tolerated.”

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  • commented 2017-04-23 09:21:53 -0600
    Given that production of albumin is one of the most important functions of the liver. You would think this would be standard therapy already. Puzzling.

    Serum albumin is the main protein of human blood plasma.7 It binds water, cations (such as Ca2+, Na+ and K+), fatty acids, hormones, bilirubin, thyroxine (T4) and pharmaceuticals (including barbiturates): its main function is to regulate the Oncotic pressure of blood. Alpha-fetoprotein (alpha-fetoglobulin) is a fetal plasma protein that binds various cations, fatty acids and bilirubin. Vitamin D-binding protein binds to vitamin D and its metabolites, as well as to fatty acids. The isoelectric point of albumin is 4.9.
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